Table 2.

Teaching points

Malakoplakia of the kidney allograft
•Malakoplakia is a rare granulomatous condition that results from abnormal macrophage response to infection
•Malakoplakia is typically associated with E. coli or other gram-negative bacilli involving the urinary tract, and can affect the native or transplanted kidney
•Biopsy of affected tissues demonstrates diagnostic von Hansemann cells (enlarged macrophages) with Michaelis-Gutmann bodies (densely calcified cores composed of undigested bacteria and bacterial products)
•Malakoplakia of the kidney transplant can be treated successfully with appropriate antimicrobial therapy and reduction of immunosuppression