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A very complicated UTI: malakoplakia following E. coli urinary tract infection

Ayotola Fatola1,2, Benjamin C Johnson3, Laura Walsh3

  • 1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. afatola1@jhmi.edu.

BMC Nephrology
|June 18, 2024
PubMed

Insights

Malakoplakia, a rare inflammatory condition, can affect the kidneys. This case shows that prompt treatment with antibiotics and immunomodulatory therapies can lead to kidney recovery in young patients.

Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Background:

  • Malakoplakia is a rare inflammatory disorder characterized by defective macrophage phagocytic function.
  • It typically presents with genitourinary, gastrointestinal, or cutaneous manifestations.
  • Hosts can be immunocompromised or, less commonly, immunocompetent.

Observation:

  • A case of renal malakoplakia in a young, healthy patient is presented.
  • The patient exhibited nephromegaly and sepsis following an Escherichia coli urinary tract infection.
  • Diagnosis and management strategies were discussed, including antibiotic selection and nephrectomy considerations.

Findings:

  • Renal malakoplakia can occur in immunocompetent individuals.
  • Prolonged antibiotic therapy combined with immunomodulatory treatments and source control can be effective.
  • Kidney recovery is possible even in severe cases.

Implications:

  • This case underscores the importance of considering malakoplakia in the differential diagnosis of renal infections, even in young, healthy patients.
  • It highlights the potential for successful conservative management, avoiding nephrectomy.
  • Further research into immunomodulatory therapies for malakoplakia is warranted.
Keywords:
E. coli UTIMalakoplakiaMichaelis-gutmann bodies

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