Presacral malakoplakia presenting as foot drop: a case report

Area of Science:

• Pathology
• Immunology
• Genetics

Background:

• Malakoplakia is a rare inflammatory condition characterized by soft tissue masses, often associated with chronic infections and innate immunity defects.
• Management relies on case reports and biological understanding due to a lack of clinical trials.

Observation:

• A case of presacral malakoplakia in a woman presenting with unilateral foot drop after intrapelvic sepsis post-cesarean delivery.
• Surgical resection of the presacral mass was not feasible.
• The patient received antibiotics, a cholinergic agonist, and ascorbic acid, showing a good response.

Findings:

• The patient responded well to medical management for both initial treatment and recurrence.
• Whole exome sequencing did not identify a clear causal variant.
• Histological examination is crucial for diagnosing malakoplakia.

Implications:

• This case suggests that surgical intervention may not always be required for favorable clinical and radiological outcomes in presacral malakoplakia.
• The diagnosis of malakoplakia should be considered in cases of soft tissue masses near chronic infection sites.
• Effective medical management strategies can be employed for malakoplakia.