Surgically Managed Malakoplakia of the Spine: A Case Report

Amy L. Xu; Olivia Petrusky; Jacob Babu; Kevin Y. Wang; Wesley M. Durand; John M. Gross; Brian J. Neuman

doi:10.2106/JBJS.CC.21.00328

Surgically Managed Malakoplakia of the Spine: A Case Report

Amy L. Xu, Olivia Petrusky, Jacob Babu, Kevin Y. Wang, Wesley M. Durand, John M. Gross, Brian J. Neuman

Research output: Contribution to journal › Article › peer-review

Abstract

Case:A 66-year-old woman with polymyositis and recurrent urinary tract infections presented with lumbar pain and progressive lower extremity neuropathy. Imaging showed lytic destruction of the vertebral bone from L2 to L4 with extension into adjacent musculature. Histological examination demonstrated Michaelis-Gutmann bodies consistent with malakoplakia. The patient underwent revision T12-sacrum posterior fusion, L2-5 laminectomy, and anterior L3-4 corpectomy, followed by L2-4 anterior stabilization and a 6-week course of ceftriaxone. At 3 months postoperatively, she was asymptomatic without recurrence.Conclusion:Malakoplakia of bone should be considered in the differential diagnosis of lytic bone lesions and can be effectively treated with surgical debulking with penetrative antibiotics.

Original language	English
Article number	e21.00328
Journal	JBJS case connector
Volume	11
Issue number	3
DOIs	https://doi.org/10.2106/JBJS.CC.21.00328
State	Published - Sep 2 2021

Keywords

E. coli
Michaelis-Gutmann bodies
adult
bone lesion
corpectomy
gout
hypertension
laminectomy
lumbar spinal fusion
malakoplakia
polymyositis
spine
urinary tract infection

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10.2106/JBJS.CC.21.00328

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title = "Surgically Managed Malakoplakia of the Spine: A Case Report",

abstract = "Case:A 66-year-old woman with polymyositis and recurrent urinary tract infections presented with lumbar pain and progressive lower extremity neuropathy. Imaging showed lytic destruction of the vertebral bone from L2 to L4 with extension into adjacent musculature. Histological examination demonstrated Michaelis-Gutmann bodies consistent with malakoplakia. The patient underwent revision T12-sacrum posterior fusion, L2-5 laminectomy, and anterior L3-4 corpectomy, followed by L2-4 anterior stabilization and a 6-week course of ceftriaxone. At 3 months postoperatively, she was asymptomatic without recurrence.Conclusion:Malakoplakia of bone should be considered in the differential diagnosis of lytic bone lesions and can be effectively treated with surgical debulking with penetrative antibiotics.",

keywords = "E. coli, Michaelis-Gutmann bodies, adult, bone lesion, corpectomy, gout, hypertension, laminectomy, lumbar spinal fusion, malakoplakia, polymyositis, spine, urinary tract infection",

author = "Xu, {Amy L.} and Olivia Petrusky and Jacob Babu and Wang, {Kevin Y.} and Durand, {Wesley M.} and Gross, {John M.} and Neuman, {Brian J.}",

note = "Publisher Copyright: {\textcopyright} 2021 by the Journal of Bone and Joint Surgery, Incorporated.",

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T2 - A Case Report

AU - Xu, Amy L.

AU - Petrusky, Olivia

AU - Babu, Jacob

AU - Wang, Kevin Y.

AU - Durand, Wesley M.

AU - Gross, John M.

AU - Neuman, Brian J.

PY - 2021/9/2

Y1 - 2021/9/2

N2 - Case:A 66-year-old woman with polymyositis and recurrent urinary tract infections presented with lumbar pain and progressive lower extremity neuropathy. Imaging showed lytic destruction of the vertebral bone from L2 to L4 with extension into adjacent musculature. Histological examination demonstrated Michaelis-Gutmann bodies consistent with malakoplakia. The patient underwent revision T12-sacrum posterior fusion, L2-5 laminectomy, and anterior L3-4 corpectomy, followed by L2-4 anterior stabilization and a 6-week course of ceftriaxone. At 3 months postoperatively, she was asymptomatic without recurrence.Conclusion:Malakoplakia of bone should be considered in the differential diagnosis of lytic bone lesions and can be effectively treated with surgical debulking with penetrative antibiotics.

AB - Case:A 66-year-old woman with polymyositis and recurrent urinary tract infections presented with lumbar pain and progressive lower extremity neuropathy. Imaging showed lytic destruction of the vertebral bone from L2 to L4 with extension into adjacent musculature. Histological examination demonstrated Michaelis-Gutmann bodies consistent with malakoplakia. The patient underwent revision T12-sacrum posterior fusion, L2-5 laminectomy, and anterior L3-4 corpectomy, followed by L2-4 anterior stabilization and a 6-week course of ceftriaxone. At 3 months postoperatively, she was asymptomatic without recurrence.Conclusion:Malakoplakia of bone should be considered in the differential diagnosis of lytic bone lesions and can be effectively treated with surgical debulking with penetrative antibiotics.

KW - E. coli

KW - Michaelis-Gutmann bodies

KW - adult

KW - bone lesion

KW - corpectomy

KW - gout

KW - hypertension

KW - laminectomy

KW - lumbar spinal fusion

KW - malakoplakia

KW - polymyositis

KW - spine

KW - urinary tract infection

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M1 - e21.00328

ER -

Surgically Managed Malakoplakia of the Spine: A Case Report

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