Malakoplakia is a rare chronic inflammatory disease of the urinary tract, usually caused by Escherichia coli infection. We report a 75-year-old woman who presented with hydronephrosis and pyuria associated with E. coli infection. Abdominal computed tomography revealed several renal stones and severe hydronephrosis of the right kidney. Biopsies of the urinary bladder and ureter revealed erosion and acute inflammation. According to a culture sensitivity test, antimicrobial treatment was

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... with cephradine 500 mg every 6 hours and amoxicillin-clavulanic acid 100 mg twice daily for 1 month. Because of the advanced hydronephrosis with impaired renal function, a right nephroureterectomy was performed. Malakoplakia of the right kidney, ureter and urinary bladder was confirmed by pathology with Michaelis-Gutmann bodies present in the surgical specimen. The patient tolerated the operation well. She regained a good health status and was regularly followed-up in the urologic department. [Tzu Chi Med J 2010;22(2):103-105]