An adult case of cerebral malakoplakia successfully cured by treatment with antibiotics, bethanechol and ascorbic acid

Fudaba, Hirotaka; Ooba, Hiroshi; Abé, Tatsuya; Kamida, Tohru; Wakabayashi, Yukihiro; Nagatomi, Hirofumi; Fujiki, Minoru

doi:10.1016/j.jns.2014.05.006

Cited by 14 publications

(12 citation statements)

References 15 publications

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“…Currently, antibiotics, combined with surgery, provide the best therapeutic protocol. A novel protocol, including antibiotics, bethanechol and ascorbic acid, has been recently used in the treatment of cerebral malacoplakia [10]. In the case herein reported the patient was treated with uterine curettage, combined with quinolones antibiotic therapy, obtaining a rapid clinical improvement, with satisfactory disappearance of symptoms, as also reported by the patient.…”

Section: Discussionsupporting

confidence: 54%

Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report

2020

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Background: Malacoplakia is a rare chronic inflammatory disease. The name derives from the Greek "μαλακός" meaning "soft" and "πλάξ" meaning "plaque", describing its usual macroscopic presentation as a friable yellow soft plaque. It was first described by von Hansemann in 1901 and by Michaelis and Gutmann in 1902. The urinary system is the most commonly involved site. Female genital tract involvement is extremely rare. Treatment is prevalently based on antibiotics with surgical intervention sometimes necessary. Prognosis is usually good, but relapse may frequently occur. Case presentation: This report illustrates the first case of endometrial malacoplakia in a 40 years-old patient who received endometrial curettage due to the retention of placental rests following an abortion. After conspicuous vaginal sero-hematic secretions, the patient received a further curettage. The histological examination did not show any retention of chorionic rests, but an endometrial and myometrial infiltration of histiocytes with large granular cytoplasm within a chronic inflammatory background. Immunoreactivity for CK-pool was negative, while CD68 immunostaining was strongly positive. Conclusions: Malacoplakia of endometrium is an extremely rare condition, with few cases reported in the whole international literature. In this paper, we present the first case associated to an abortion followed by endometrial curettage procedures. This rare disease should always be attentively examined, considering, among differential diagnoses, uterine neoplasms or physiological conditions such as cumulus of foamy macrophages in the endometrium.

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Section: Discussionsupporting

confidence: 54%

Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report

2020

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“…Other associated pathogens include mycobacteria, Staphylococcus aureus, Pasturella multocida, Stenotrophomonas maltophilia, Whipple's disease and syphilis (3,(11)(12)(13)(14)(15). In addition, concomitant infections with non-bacterial agents including Candida albicans, Paracoccidioides brasiliensis, parasites such as Taenia species and viruses including Herpes simplex and Human papilloma virus have been described (3,12,(15)(16)(17)(18). Given that phagocytosis appears to be central to the pathogenesis, both host and microbial factors warrant further investigation for the identification of specific molecular mechanisms linking innate immune responses and pathogen recognition in malakoplakia.…”

Section: Discussionmentioning

confidence: 99%

Malakoplakia in Thoracic Transplant Recipients

Lane

Kradin

Xia

et al. 2019

Transplantation Proceedings

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Malakoplakia is a rare granulomatous disease characterized by the presence of Michaelis-Gutmann bodies on histopathologic analysis. Lesions manifest in a wide range of organs with cutaneous, gastrointestinal and genitourinary systems being most common and often result in significant co-morbidities owing largely to misdiagnoses and the similar appearance to malignancy or granulomatous processes. Most patients are immunocompromised, including the solid organ transplant population. Amongst organ recipients, malakoplakia is most commonly seen in renal transplantation, and only rarely reported in thoracic organ recipients. Here, we report two cases of malakoplakia in thoracic transplant patients that highlight the critical need for tissue diagnosis to avoid delay in management.

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“…As the E coli isolated from our patient was resistant to ciprofloxacin and trimethoprim/sulfamethoxazole, both of which have good intracellular penetration and have demonstrated success with this condition, 17,23 we selected azithromycin for long‐term antibiotic therapy based on the sensitivity profile and in particular because of favorable intracellular penetration characteristics. Adjunct therapies include cholinergic agonists, such as bethanechol, to augment macrophage function, 24 ascorbic acid, 25 and even oral budesonide, 26 but there is a dearth of robust literature beyond case reports to routinely support any of these therapies.…”

Section: Discussionmentioning

confidence: 99%

Colonic malakoplakia in a dual stem cell and cardiac transplant recipient: A case report and literature review

Meredith

Dharan

Killen

et al. 2020

Transplant Infectious Dis

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We describe the first published case of malakoplakia in a dual stem cell and cardiac transplant recipient. In the 2 months following cardiac transplantation, our patient developed persistent diarrhea and recurrent E coli bacteremia. Biopsies obtained from areas of colonic thickening revealed malakoplakia. Despite improvement in symptoms with prolonged antimicrobial therapy and reduction of his immunosuppression, he eventually died from sepsis. Our case highlights not only the importance of the timely diagnosis of this rare disorder, but also the difficulty in determining optimal treatment duration, particularly where excision of involved areas is not possible, as data on this disease are lacking. Here we describe our case and review the available literature published on malakoplakia in the cardiac transplant population.

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An adult case of cerebral malakoplakia successfully cured by treatment with antibiotics, bethanechol and ascorbic acid

Cited by 14 publications

References 15 publications

Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report

Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report

Malakoplakia in Thoracic Transplant Recipients

Colonic malakoplakia in a dual stem cell and cardiac transplant recipient: A case report and literature review

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