Publication Date
1-1-2024
Journal
SAGE Open Medical Case Reports
DOI
10.1177/2050313X241239866
PMID
38505578
PMCID
PMC10949541
PubMedCentral® Posted Date
3-18-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Malakoplakia, renal transplant recipient, pediatric, recurrent gastrointestinal infections
Abstract
Malakoplakia is a rare, chronic granulomatous disease that mainly affects the genitourinary system of immunocompromised adults. It is caused by a bactericidal deficit in macrophages and, therefore, the treatment includes antimicrobials that reach high concentrations in macrophages. To our knowledge, we present the first case of malakoplakia in a pediatric solid organ transplant recipient. Our patient is a 15-year-old male renal transplant recipient who presented with recurrent diarrhea. Blood, urine, and gastrointestinal pathogen panel testing were positive for enteroaggregative Escherichia coli. A colonoscopy revealed diffuse malakoplakia. He had a complete resolution of symptoms with trimethoprim-sulfamethoxazole therapy. Unfortunately, his malakoplakia recurred after 9 months prompting the transition of therapy to oral gentamicin with subsequent remission. Malakoplakia should be considered in the differential of solid organ transplant recipients with recurrent gastrointestinal infections.
Included in
Digestive System Diseases Commons, Gastroenterology Commons, Medical Sciences Commons, Pediatrics Commons