title: [Case of renal parenchymal malakoplakia presenting as sepsis and treated with nephrectomy].
abstract: Malakoplakia is a rare chronic inflammatory condition characterized by defective macrophage function, most of which involve the genitourinary tract, and renal parenchymal involvement is uncommon. We present a case of malakoplakia affecting renal parenchyma. A 46-year-old woman with pyrexia and jaundice was referred to our department. Abdominal enhanced CT scan revealed a left pyelonephritis with ureteral stone and bilateral renal abscesses. Despite the insertion of a left ureteral stent and administration of antibiotics, the patient showed persistent high fever and elevated CRP, and no obvious improvement in clinical and imaging data. In view of the limited effectiveness of the conservative treatment in this case, we decided to perform left nephrectomy. The diagnosis of malakoplakia was made based on the histopathological findings of von Hansemann cells and Michaelis-Guttmann bodies detected in the nephrectomy specimen. She is clinically healthy up to the present (50 months after surgery) with normal clinical indicators and CT findings.
authors.affiliation: Department of Urology, St. Marianna University School of Medicine.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kitajima
authors.forename: Junki
authors.initials: J
authors.lastname: Koike
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Koizumi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Udagawa
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kudo
authors.forename: Ryuto
authors.initials: R
authors.lastname: Nakazawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Sasaki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsutsumi
authors.forename: Satetsu
authors.initials: S
authors.lastname: Miyano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Chikaraishi
mesh_terms: D000038:Abscess / Q000150:complications; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007565:Jaundice / Q000209:etiology; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008287:Malacoplakia / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009392:Nephrectomy; D011704:Pyelonephritis / Q000150:complications; D018805:Sepsis / Q000209:etiology*; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000150:complications