Malakoplakia and tuberculosis

Govender, Dhirendra; Essa, Ahmed S.

doi:10.1080/003130299105160

Cited by 24 publications

(27 citation statements)

References 16 publications

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“…The prolonged course of antibiotics or combined use of quinolone antibiotics together with trimethoprim-sulfamethoxazole has been shown to improve the outcome of malakoplakia [5,7,12,13]. As the etiology of malakoplakia was related to immunosuppression, several studies report that the disease regressed when the patient was rendered into a less immunosuppressed state [7,9,12].…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, an abnormal or altered immune response has been implicated in the pathogenesis, and an immunocompromised status is associated with the pathogenesis [7]. The third hypothesis is an abnormal macrophage response because of defective lysosomal function [8,9]. It is suggested that macrophages in malakoplakia are capable of phagocytosis but unable to digest the bacteria.…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of malakoplakia is not well understood, and several possible mechanisms have been suggested [6][7][8][9]. First, microorganisms play a role in the pathogenesis, in particularly E. coli, Proteus and Mycobacterium tuberculosis [6].…”

Section: Discussionmentioning

confidence: 99%

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Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Wong¹,

Yeung²,

Lee³

et al. 2016

JCR

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Abstract:Introduction: Malakoplakia is a rare chronic inflammatory disease which commonly affects the urogenital tract. The exact pathogenesis is not fully understood, but some associated conditions which include immunodeficiency, malignancy or chronic bacterial infection, have been suggested. The definite diagnosis relies on identifying the Michaelis-Gutmann bodies microscopically. Case Report: A 62-year-old woman with poorly controlled diabetes mellitus presented with gross hematuria for a few months. Subsequent investigations showed a positive urine culture (Escherichia coli -E. coli), and flexible cystoscopy showed a 1 cm plaque-like lesion at the left posterior wall of the urinary bladder as well as several smaller, similar lesions noted at various different sites. Biopsy of the lesion showed a proliferation of macrophages (CD68+) with abundant, glandular cytoplasm and the presence of Michaelis-Gutmann bodies (PAS+, Von Kossa+), which was consistent with malakoplakia. Computed Tomography (CT) urogram showed no hydronephrosis, with good contrast excretion from both kidneys as well as satisfactory drainage down to the bladder. She was then treated with antibiotics, but still had on and off urinary tract infection. About a year later, she presented with urosepsis and acute renal failure, and was admitted to the urological ward. Urgent CT urogram showed bilateral hydronephrosis with both lower ureters distended with hyperdense contents (malakoplakia plaques). Emergency bilateral percutaneous nephrostomy (PCN) was performed. Her condition was stabilized with antibiotics, and her renal function improved with PCN drainage. Several treatment options were offered to the patient, but in view of her significant pre-morbid condition, she opted for bilateral long-term PCN. Conclusion: Malakoplakia was thought to be a treatable and relatively benign disease, but in some cases, it might result in renal failure due to bilateral ureteric involvement. Early diagnosis together with adequate antibiotic treatment is important in patients with malakoplakia, and they should be closely followed up to prevent future development of renal insufficiency.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Wong¹,

Yeung²,

Lee³

et al. 2016

JCR

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“…Therefore, malakoplakia and tuberculosis may have occurred coincidentally. Govender and Essa [19]reported a case of malakoplakia with tuberculosis presenting as soft tissue mass in the left anterior neck following treatment of pulmonary tuberculosis. It is postulated that the association or coincidence of malakoplakia with sarcoidosis, mycosis and mycobacterial infections and other debilitating disorders, such as diabetes mellitus, or an immunocompromised state following steroid therapy may suggest an altered host immunity and a failure of the immune system to resolve a low-grade infection.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Malakoplakia Coexistent with Tuberculosis of the Hilar Lymph Node Mimicking Malignancy

Pang

2005

Respiration

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Pulmonary malakoplakia is a disease that is difficult to diagnose because its symptoms vary from those mimicking bronchogenic carcinoma to pneumonitis-like tuberculous infections. Malakoplakia is an unusual inflammatory condition characterized by the accumulation of macrophages with diagnostic Michaelis-Gutmann bodies. In this study, an immunocompromised patient with a tumor mass in the upper lobe of the right lung coexisting with hilar node enlargement is presented. A thoracoscopic biopsy revealed pulmonary malakoplakia with tuberculosis of the hilar lymph node. Microbiologic cultures were positive for acid-fast positive bacilli from the hilar node specimen, and negative for any other microorganisms such as Rhodococcus equi, but positive for Escherichia coli from the lung specimen. The significance of these findings and the coincidental association between malakoplakia and tuberculosis are discussed.

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“…Other harbouring structures include testis, epididymis, lymph nodes, ear, nasopharynx, tonsils and retroperitoneal tissue (2,3). Some authors have reported that this pathology could develop in patients with diabetes mellitus with non-controlled hyperglycaemia (4) and tuberculosis (5). It rarely develops in the lung and when present, it is usually associated with AIDS or other types of immunodeficiencies (6).…”

Section: Introductionmentioning

confidence: 97%

Pulmonary Malacoplakia

Kiliggun

Turna

Gürses

2006

Acta Chirurgica Belgica

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We report a case of a 76-year-old man with bilateral pulmonary and pleural nodules and type 2 diabetes mellitus. Laboratory investigations revealed no sign of immunodeficiency. Pleural, pulmonary and diaphragmatic biopsies were taken through a mini-thoracotomy. Pathology showed Michaelis-Gutmann inclusion bodies and diagnosis of malacoplakia was made. Malacoplakia masquerading as bilateral tumour masses was thought to be noteworthy especially in an immunocompetent patient.

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Malakoplakia and tuberculosis

Cited by 24 publications

References 16 publications

Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Pulmonary Malakoplakia Coexistent with Tuberculosis of the Hilar Lymph Node Mimicking Malignancy

Pulmonary Malacoplakia

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