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Journal of the American Veterinary... Dec 2021A 4-month-old 5.9-kg sexually intact female French Bulldog was presented because of recurrent urinary tract infections in combination with pollakiuria, hematuria, and...
CASE DESCRIPTION
A 4-month-old 5.9-kg sexually intact female French Bulldog was presented because of recurrent urinary tract infections in combination with pollakiuria, hematuria, and urinary incontinence.
CLINICAL FINDINGS
A diagnosis of malakoplakia was made on the basis of results of hematologic and serum biochemical testing, abdominal ultrasonography, bacterial culture, and cystoscopic biopsies of the urinary bladder wall. Biopsy samples were sent for routine histologic examination and fluorescence in situ hybridization to confirm the presence of intracellular and subendothelial bacteria.
TREATMENT AND OUTCOME
Treatment with enrofloxacin was started after the diagnosis of malakoplakia was confirmed. During treatment, polypoid changes in the urinary bladder decreased dramatically but did not disappear. On follow-up ultrasonography after 12 weeks of treatment, marked improvement was visible and results of repeated bacterial culture and fluorescence in situ hybridization of bladder wall samples were negative. The patient was free from clinical signs and had an ultrasonographically normal urinary bladder 59 weeks after antimicrobial treatment was discontinued.
CLINICAL RELEVANCE
Malakoplakia, a granulomatous disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria, is a very rare disease in dogs, but early suspicion of the condition is essential to allow timely diagnosis and avoid disease progression and the need for prolonged treatment. Malakoplakia should be considered in young dogs with chronic urinary tract infections; the diagnosis can be made through a combination of histologic examination and fluorescence in situ hybridization of bladder wall biopsy samples.
Topics: Animals; Dog Diseases; Dogs; Female; In Situ Hybridization, Fluorescence; Malacoplakia; Urinary Bladder; Urinary Bladder Diseases; Urinary Tract Infections
PubMed: 34968189
DOI: 10.2460/javma.20.12.0676 -
Urology Case Reports Jan 2022Granulomatous prostatitis is a rare condition that is diagnosed only by histopathological examination. Though rare, the condition was reported to have different...
Granulomatous prostatitis is a rare condition that is diagnosed only by histopathological examination. Though rare, the condition was reported to have different presentations (mimicking prostate cancer or prostatitis and prostatic abscess) and to have different etiologies which classified it into three main entities; nonspecific (idiopathic), post-surgery, and specific. Specific granulomatous prostatitis is further sub-classified to infective, xanthogranulomatous, Malacoplakia and associated with systemic granulomatous disease and allergy. We hereby report a rare case of xanthogranulomatous prostatitis that presented with persistent urinary tract infection.
PubMed: 34712584
DOI: 10.1016/j.eucr.2021.101887 -
The Journal of International Medical... Oct 2021Malakoplakia, a rare acquired granulomatous disease, affects many systems, including the urogenital tract. The literature describes malakoplakia of different viscera,...
Malakoplakia, a rare acquired granulomatous disease, affects many systems, including the urogenital tract. The literature describes malakoplakia of different viscera, and satisfactory results have been obtained after treatment. We reported a 48-year-old patient with diabetes who received multiple treatments in our hospital for bladder malakoplakia near the ureteral orifice. Despite aggressive treatment, the patient had recurrent bladder malakoplakia and even developed right ureteral orifice stenosis, which resulted in urinary obstruction and hydronephrosis. We believe that malakoplakia in the bladder near ureteral orifice should receive more attention. Satisfactory results may not be obtained through antibiotic treatment alone, and early antibiotic therapy combined with full surgical excision may be a better choice.
Topics: Cystitis; Humans; Hydronephrosis; Malacoplakia; Middle Aged; Ureter
PubMed: 34637357
DOI: 10.1177/03000605211050799 -
Frontiers in Medicine 2021Colonization of rarely occurs in a graft. This study reports a case of malacoplakia and cryptococcoma caused by and in a transplanted kidney, with detailed pathology...
Colonization of rarely occurs in a graft. This study reports a case of malacoplakia and cryptococcoma caused by and in a transplanted kidney, with detailed pathology and metagenome sequencing analysis. We presented a case of cryptococcoma and malacoplakia in the genitourinary system including the transplant kidney, bladder, prostate, and seminal vesicles caused by and in a renal-transplant recipient. Metagenome sequencing was conducted on a series of samples obtained from the patient at three different time points, which we termed Phase I (at the diagnosis of cryptococcoma), Phase II (during perioperative period of graftectomy, 3 months after the diagnosis), and Phase III (2 months after graftectomy). Sequencing study in the Phase I detected two and four sequences of respectively in cerebrospinal fluid (CSF) and feces, with resistant presented in urine and renal mass. A 3-month antibiotic treatment yielded a smaller bladder lesion but an enlarged allograft lesion, leading to a nephrectomy. In the Phase II, two sequences of were detected in CSF, while the continued as before. In the Phase III, the lesions were generally reduced, with one sequence in feces only. The existence and clearance of sequences in CSF without central nervous system symptoms may be related to the distribution of infection foci , the microbial load, and the body's immunity. Overall, this study highlights the need for enhanced vigilance against uncommon types of infections in immunocompromised populations and increased concern about the potential correlation between and infections.
PubMed: 34595189
DOI: 10.3389/fmed.2021.721145 -
Medicine Sep 2021Malakoplakia and xanthogranulomatous pyelonephritis are chronic inflammatory conditions of the kidney characterized by the infiltration of inflammatory cells.
RATIONALE
Malakoplakia and xanthogranulomatous pyelonephritis are chronic inflammatory conditions of the kidney characterized by the infiltration of inflammatory cells.
PATIENT CONCERNS
An 82-year-old female patient had a history of hypertension, type 2 diabetes mellitus, dyslipidemia, and end-stage renal disease under hemodialysis. She was admitted repeatedly 4 times within 4 months due to urosepsis.
DIAGNOSIS
The enlarged right kidney with a low-density lesion at the right middle calyx, and a well-enhanced ureter were noted on the computed tomography scan. Therefore, xanthogranulomatous inflammation was suspected. Semi-rigid ureteroscopy with biopsy was performed, and xanthogranulomatous inflammation of the ureter was confirmed on the pathology report.
INTERVENTIONS
After right open radical nephrectomy was performed, the final pathology report revealed malakoplakia with xanthogranulomatous pyelonephritis.
OUTCOMES
After the surgery, she has no longer suffered from urosepsis for 8 months, and there were no adverse event or recurrence noted.
LESSONS
With this case report, we aim to emphasize that these 2 diseases are not mutually exclusive, but they may exist simultaneously in the same patient.
Topics: Aged, 80 and over; Diagnosis, Differential; Female; Humans; Kidney Failure, Chronic; Malacoplakia; Nephrectomy; Pyelonephritis, Xanthogranulomatous; Tomography, X-Ray Computed
PubMed: 34516505
DOI: 10.1097/MD.0000000000027137 -
BMJ Case Reports Aug 2021A 45-year-old woman presented to us in March 2019 with complaints of fever and right lower quadrant abdominal pain for 1 month. She had undergone renal transplantation...
A 45-year-old woman presented to us in March 2019 with complaints of fever and right lower quadrant abdominal pain for 1 month. She had undergone renal transplantation in 2017 for end-stage renal disease and developed four episodes of urinary tract infection in the next 16 months post transplantation, which were treated based on culture reports. She was subsequently kept on long-term prophylaxis with trimethoprim and sulfamethoxazole. Her present laboratory parameters showed a normal blood picture and elevated creatinine. Urine culture grew Non-contrast CT of the abdomen-pelvis revealed an endo-exophytic hyperdense mass in the graft kidney showing local infiltration and associated few regional lymph nodes. PET-CT revealed the soft-tissue mass and regional lymph nodes to be hypermetabolic, raising the possibility of lymphoma. However, biopsy showed features of malakoplakia. She was subsequently initiated on long-term antibiotic therapy and her immunosuppression decreased.
Topics: Female; Humans; Kidney Transplantation; Lymphoproliferative Disorders; Malacoplakia; Middle Aged; Positron Emission Tomography Computed Tomography; Urinary Tract Infections
PubMed: 34400429
DOI: 10.1136/bcr-2021-244228 -
BMJ Case Reports Jul 2021Malakoplakia is a rare chronic inflammatory condition, which primarily occurs in genitourinary tract, with prostatic malakoplakia being extremely rare. We present two...
Malakoplakia is a rare chronic inflammatory condition, which primarily occurs in genitourinary tract, with prostatic malakoplakia being extremely rare. We present two cases of acute urinary retention, with clinically firm nodular prostate and a raised serum prostate-specific antigen. Transrectal ultrasound-guided prostatic biopsy showed features of malakoplakia. There was a significant reduction of size of prostate on transrectal ultrasonography after 4 weeks of antibiotics. However, one patient had failed trial without catheter and was subjected to transurethral resection of prostate. The biopsy of the prostatic chips also showed features of malakoplakia. Other patient improved symptomatically after antibiotics and was managed conservatively. Both the patients are on regular follow-up and are asymptomatic. Prostatic malakoplakia presenting as urinary retention is very uncommon with around 12 cases in the literature. Recognition of prostatic malakoplakia is important because clinically it can masquerade prostatic malignancy. Treatment with antibiotics is necessary before subjecting the patients for surgery in patients with obstructive symptoms.
Topics: Humans; Malacoplakia; Male; Prostatic Neoplasms; Transurethral Resection of Prostate; Urinary Retention
PubMed: 34321270
DOI: 10.1136/bcr-2021-243927 -
Journal of Surgical Case Reports Jun 2021Malakoplakia is a rare disease. Clinical presentation is non-specific, making its diagnosis an incidental finding on histopathological analysis. The aim of this case...
Malakoplakia is a rare disease. Clinical presentation is non-specific, making its diagnosis an incidental finding on histopathological analysis. The aim of this case report is to describe a patient diagnosed with colon, renal and soft tissue malacoplakia mimicking a locally advanced colorectal cancer. A 75-year-old man was admitted due to intense abdominal pain. No relevant findings at the physical examination. Computed tomography showed parietal thickening of the descending colon with left kidney, iliopsoas muscle and retroperitoneum involvement. An elevated blood serum creatinine, elevated glycated hemoglobin and urinary infection were detected. Surgery was decided for suspicious symptomatic colonic neoplasm. Left segmental colectomy with left partial nephrectomy and retroperitoneal soft tissue resection was performed. Pathology report was compatible with malakoplakia. Malakoplakia is a rare disease and may affect multiple organs. Because there are no clinical-specific findings, diagnosis is usually made with histopathological study of the surgical specimen.
PubMed: 34104407
DOI: 10.1093/jscr/rjab225 -
Indian Journal of Cancer 2021
Topics: Humans; Magnetic Resonance Imaging; Malacoplakia; Male; Middle Aged
PubMed: 34100418
DOI: 10.4103/ijc.IJC_164_20 -
Veterinary Pathology Jul 2021Malakoplakia in humans most often affects the urinary bladder and is characterized by inflammation with von Hansemann-type macrophages, with or without Michaelis-Gutmann...
Malakoplakia in humans most often affects the urinary bladder and is characterized by inflammation with von Hansemann-type macrophages, with or without Michaelis-Gutmann bodies, and is frequently associated with infection. We describe the microscopic features of malakoplakia in the urinary bladder of 4 puppies. In all cases, the lamina propria of the urinary bladder was markedly expanded by sheets of large, round to polygonal macrophages with intracytoplasmic, periodic acid-Schiff-positive granules and granular inclusions, and rare Prussian blue-positive inclusions. Macrophages were positive for CD18 and Iba1. In 2 cases, Michaelis-Gutmann bodies were detected with hematoxylin and eosin stain and were best demonstrated with von Kossa stain. infection was confirmed in 2 cases with bacterial culture or polymerase chain reaction (PCR) and sequencing of the bacterial 16S ribosomal RNA gene. Transmission electron microscopy of one case demonstrated macrophages with abundant lysosomes, phagolysosomes, and rod-shaped bacteria. Microscopic features were similar to human cases of malakoplakia. In dogs, the light microscopic characteristics of malakoplakia closely resemble granular cell tumors and histiocytic ulcerative colitis.
Topics: Animals; Dog Diseases; Dogs; Escherichia coli; Inclusion Bodies; Macrophages; Malacoplakia; Urinary Bladder
PubMed: 33888013
DOI: 10.1177/03009858211009779