Abstract
Malacoplakia is a rare disease of the urinary tract, especially in children, with only 15 reported pediatric cases in the English literature. We report on a 16-year-old girl who presented with renal insufficiency and multiple bladder masses. CASE REPORT A 16-year-old girl was admitted to the hospital for a possible seizure. Evaluation revealed a creatinine of 3.0 mg/dl (normal 0.7 to 1.5) and an Escherichia coli urinary tract infection. The patient had developmental delay and was unable to give a reliable symptom history but the family denied any history of flank pain, urinary tract infection, dysuria, hematuria, frequency or incontinence. She was on no medications at home. Renal ultrasonography demonstrated echogenic kidneys bilaterally with caliceal dilatation and multiple polypoid solid bladder masses with blood flow by color Doppler (fig. 1). Diuretic renography showed minimal function of the left kidney but no obstruction. Voiding cystourethrography revealed multiple filling defects in the bladder and grade I vesicoureteral reflux bilaterally. Retrograde pyelograms demonstrated dilatation of the calices bilaterally, normal ureters and no filling defects in the upper tracts. Cystoscopy showed multiple yellow-tan polypoid smooth masses, which were biopsied. Histological changes were consistent with malacoplakia. The patient was never febrile while in the hospital and the seizure evaluation was negative. She was discharged home on oral fluoroquinolone and bethanechol therapy for 3 months. She remained asymptomatic. Followup ultrasonography revealed resolution of the bladder polyps and no change in the kidneys. Repeat bladder biopsy was negative for malacoplakia. Urine culture was negative off of antibiotic prophylaxis. DISCUSSION
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
