Cases reported "Malacoplakia"

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1/80. Pulmonary malacoplakia associated with rhodococcus equi infection in a patient with AIDS.

    An AIDS patient with a cavitary lung lesion was found to have pulmonary malacoplakia associated with rhodococcus equi infection. The diagnosis was based on the typical histologic features of transbronchial biopsy and a positive bacterial culture. All 13 reported cases of AIDS patients with pulmonary malacoplakia were associated with R equi. The recognition of this unique entity is important because of its responsiveness to therapy.
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keywords = infection
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2/80. Renal malacoplakia: an important consideration in the differential diagnosis of renal masses in the presence of escherichia coli infection.

    Renal malacoplakia is an uncommon condition with a variety of radiological characteristics which may initially suggest an alternative diagnosis. Three cases of renal malacoplakia were diagnosed in our hospital during a 2 year period. This apparent cluster of cases probably reflects the increased use of imaging and biopsy in the investigation of elderly hospitalized patients. It is important to make a definitive diagnosis as correct management may result in cure.
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keywords = infection
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3/80. Malakoplakia of the caecum in a kidney-transplant recipient: presentation as acute tumoral perforation and fatal outcome.

    Malakoplakia is a rare pseudotumoral inflammatory disease known to affect immunocompromised subjects, mainly with a history of recurrent escherichia coli infection. The urinary tract is the most frequent site of the disease, although all organs can be involved. In the present article, we report a case of malakoplakia of the caecum, that developed in a 52-year-old man, who had received a kidney transplant 9 years before and had a history of recurrent E. coli urinary tract infections. Malakoplakia presented as acute intestinal perforation, and, despite aggressive surgical and medical management, disease progressed toward a fatal outcome due to sepsis and multiple organ failure 9 months later. A defect in the macrophagic activity was demonstrated.
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keywords = infection
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4/80. Cerebral malakoplakia associated with escherichia coli infection.

    Malakoplakia is an unusual chronic inflammatory disease occurring predominantly in the bladder and only rarely affecting other organs. For the urinary tract, its aetiology has been ascribed to the presence of escherichia coli, while the very few cases of cerebral malakoplakia which have been reported so far, have mostly occurred in infants in the clinical setting of neonatal herpes virus infection or otherwise in adults in areas of cerebral infarction. We here report a case of E. coli-associated malakoplakia of the brain. It occurred in a 53-year-old man who had undergone long-term corticosteroid therapy and had previously been operated on a cerebral E. coli-associated abscess. This case indicates that malakoplakia of the brain might also be a histiocytic reaction against bacterial antigens of the E. coli family.
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keywords = infection
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5/80. Detection of the 20-kDa virulence-associated antigen of rhodococcus equi in malakoplakia-like lesion in pleural tissue obtained from an AIDS patient.

    A malakoplakia-like lesion was detected in a pleural biopsy from an AIDS patient presenting clinical and radiologic features of pneumonia. Cultures of bronchoalveolar lavage and pleural fluid evidenced rhodococcus equi as the causative agent of pleuro-pulmonary infection. Immunochemical characterization of the R. equi isolate showed the presence of a strain similar to the ATCC 33704 reference strain presenting the capsular antigen of serotype 4, and the intermediate virulence-associated antigen of 20-kDa. Histopathology of the patient's pleural biopsy showed plaques of macrophages interspersed with lymphocytes, and intracytoplasmic cocci and bacilli in macrophages, which were variably acid-fast positive. immunohistochemistry of cocci, bacilli and their degradation products resulted strongly positive when stained with a mouse monoclonal antibody (MAb) produced against the 20-kDa antigen. This finding could have important implications for the pathogenicity of R. equi for human beings, since we do not know yet all the factors involved in the formation of malakoplakia. Indeed, the results obtained in the present study, taken together with the results obtained for pigs inoculated with R. equi strains of intermediate virulence (Madarame et al. 1998), raise the possibility that most strains presenting the 20-kDa antigen may be capable of inducing malakoplakia. If this hypothesis is confirmed by immunohistochemical analysis of human pulmonary malakoplakia cases due to R. equi, the detection of this antigen may be extremely helpful in the diagnosis and treatment of such patients. This is the first report of R. equi infection in human beings that suggests a relationship between pleural malakoplakia and the virulence-associated antigen of 20-kDa.
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6/80. Clinical and laboratory studies into the pathogenesis of malacoplakia.

    Three cases of malacoplakia are described. Electron microscopic studies revealed intact bacteria or bacteria in varying states of degradation within phagolysosomes of the malacoplakic macrophages. Michaelis-Gutmann bodies arise within the phagolysosomes. These findings suggest that the bacteria incorporated within the phagolysosomes persist as dense amorphous aggregates which later become encrusted with calcium phosphate crystals to form the laminated Michaelis-Gutmann bodies. Possible explanations for the unusual macrophage response in malacoplakia are: (1) infection with an unusual strain of bacteria, (2) an immunological abnormality affecting intracellular killing of organisms, and (3) an abnormality affecting intracellular digestion of organisms. In considering each of the possibilities, we have been unable to detect any unusual strain of infecting organisms in association with malacoplakia, and in vitro studies have revealed normal T lymphocyte response to mitogen and normal monocyte bactericidal capacity. According to the history, each patient had reason to have a compromised immune status; in only one, however, was this demonstrated.
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7/80. Malakoplakia of the colon in an infant with severe combined immunodeficiency (SCID) and charge association.

    We report on malakoplakia of the colon observed in a six month old girl in a setting of severe combined immunodeficiency (SCID) and a malformational syndrome termed CHARGE association. By the age of six months, hemorrhagic diarrhea had developed, and multiple ulcers were seen at colonoscopy. The biopsy specimen showed ulcerating malakoplakia. Immunodeficiency was primarily reflected by deprivation of CD4 cells in the peripheral blood, and CT scans failed to detect structures consistent with a normal thymus. There were also polylymphadenopathy and chronic erythroderma. The lymph node showed extreme hypoplasia of the follicular cortex and marked expansion of the paracortex. B cell counts progressively declined, and plasma cells were absent both in intact mucosa of the colon and in a lymph node. The patient died at eighteen months of respiratory failure following recurrent airway infections. Pediatric malakoplakia of the colon, though rare, may be regarded as an example of opportunistic bacterial infection in an immunocompromised host. Combined immunodeficiency (CID) has to be considered in such instances, in particular when malformational syndromes coexist affecting the development of the thymus.
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ranking = 4.4459538719787
keywords = bacterial infection, infection
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8/80. Malakoplakia of the appendix. An unusual association with eggs of taenia species.

    Malakoplakia of the appendix is an unusual condition that has been reported to occur in association with tumors, infections, and immunocompromised states. We describe a case of appendicular malakoplakia associated with eggs of taenia species. The diagnosis was made on histopathologic examination of surgically resected tissue from an appendicular mass. To the best of our knowledge, this is the first time that helminths have been documented to be associated with malakoplakia. We also discuss the implications of helminthic infestation in the pathogenesis of the lesion.
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ranking = 0.2
keywords = infection
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9/80. Malakoplakia of the kidney--a case report.

    Malakoplakia is a rare disease expressed as a special type of inflammatory reaction to infection with various bacteria and fungi. We present a case of renal malakoplakia in a 30-year-old female patient. The symptoms were not characteristic enough for making the ture diagnosis preoperatively. A preoperative diagnosis of renal cell carcinoma was made in this case.
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keywords = infection
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10/80. malacoplakia of the ovary, fallopian tube and uterus: a case associated with diabetes mellitus.

    malacoplakia is a chronic xanthogranulomatous inflammation that most commonly affects the urinary tract and the gastrointestinal system of middle-aged women. It is rarely encountered in a female genital tract, and only a handful of cases of malacoplakia of the ovary have been described. We report an unusual case of malacoplakia extensively involving the ovary, fallopian tube and uterus of a 47-year-old woman with poorly controlled diabetes mellitus. escherichia coli was cultured from the ovarian lesion. To our knowledge, such an extensive female genital malacoplakia associated with diabetes mellitus has not been reported before. Widespread or atypical site malacoplakia occurring in a patient with systemic disease may result from a diminution of macrophagocytic function, either under the influence of the systemic illness or related to corticosteroid excess. We propose that diabetes mellitus without appropriate medical control may have resulted in impaired leukocyte function which, when combined with E. coli infection, led to the development of extensive malacoplakia in the genital tract of this patient.
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keywords = infection
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