[Malacoplakia: a possible complication of poorly controlled diabetes mellitus?].
METHODS
A 47-year-old woman with poorly controlled diabetes mellitus (HbA1C 9.2%, fasting blood glucose > 200 mg/dl) had complained of moderately severe stabbing pain in the left abdomen. On admission there were no abnormal findings on abdominal palpation.


METHODS
Abdominal ultrasound and computed tomography (CT) revealed a partly solid partly cystic well-circumscribed space-occupying lesion, about 15 cm in diameter, in the left abdomen, extending from the lower third of the kidney into the pelvis.


METHODS
Biopsy of the lesion showed chronic granulating inflammation with foamy histiocytes (Hansemann macrophages) as characteristic substrate of extensive malakoplakia. Despite the size of the lesion it was not excised but long-term treatment with ciprofloxacin undertaken. At the same time, the diabetes was carefully controlled with ordinary insulin. Ten months later there was no longer any evidence of the lesion by ultrasound and CT.


CONCLUSIONS
Even extensive malakoplakia can be successfully treated with ciprofloxacin. Poorly controlled diabetes together with a weak immune status (CD4/CD8 < or = 1) may have favoured the occurrence of malakoplakia.
Eichbauer-Sturm
G
G
II. Medizinische Abteilung, Allgemeinen Krankenhauses der Stadt Linz, Osterreich.
Janko
O
O
Grafinger
P
P
Höpfl
I
I
Syré
G
G
Biesenbach
G
G
Zazgornik
D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001706:Biopsy; D002939:Ciprofloxacin / Q000627:therapeutic use; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008287:Malacoplakia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D011860:Radiography, Abdominal; D013997:Time Factors; D014463:Ultrasonography
D000890:Anti-Infective Agents; D007328:Insulin; D002939:Ciprofloxacin