[Diffuse recto-colic malacoplakia: association with cryptogenic colitis and remission following long-term antibiotic...

Diffuse digestive malakoplakia appears exceptional. A case of rectocolic malakoplakia with multiple localisations is reported in a 22 year old man presenting with inflammatory bowel disease. The most prominent clinical features were deterioration of his general condition, fever, and rectal bleeding, with fistula. Endoscopy revealed pseudotumoral masses and multiple colorectal ulcerations. Diagnosis was based on histological examination of colorectal biopsies. Clinical and histological remission was obtained after colonic diversion associated with broad spectrum antibiotherapy. These findings raise the problem of the possible association between inflammatory bowel disease and malakoplakia. They also confirm that, as previously reported, favourable outcome in digestive malakoplakia is possible.