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.
Berney
T
T
Clinic of Digestive Surgery and Transplantation, Geneva University Hospital, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.
Chautems
R
R
Ciccarelli
O
O
Latinne
D
D
Pirson
Y
Y
Squifflet
J P
JP
D016470:Bacteremia / Q000150:complications; D002429:Cecal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002430:Cecal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004927:Escherichia coli Infections / Q000150:complications; D017809:Fatal Outcome; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016030:Kidney Transplantation; D008287:Malacoplakia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D011183:Postoperative Complications; D012008:Recurrence; D014057:Tomography, X-Ray Computed