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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 wasdoi:10.1016/s1016-3190(10)60049-3 fatcat:f666uzctjnco5bj4leig2mlqui