• Yueh Pan, Ying Chui Hong, Hung-Jen Shih, Chin-Pao Chang, Sheng-Hsien Huang, Sheng-Chuan Wu, Liang-Ming Lee, Yu-Ching Wen, Chih-Chen Hsu, and Chi-Hao Hsiao.
• Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
• Medicine (Baltimore). 2021 Sep 10; 100 (36): e27137e27137.

RationaleMalakoplakia and xanthogranulomatous pyelonephritis are chronic inflammatory conditions of the kidney characterized by the infiltration of inflammatory cells.Patient ConcernsAn 82-year-old female patient had a history of hypertension, type 2 diabetes mellitus, dyslipidemia, and end-stage renal disease under hemodialysis. She was admitted repeatedly 4 times within 4 months due to urosepsis.DiagnosisThe enlarged right kidney with a low-density lesion at the right middle calyx, and a well-enhanced ureter were noted on the computed tomography scan. Therefore, xanthogranulomatous inflammation was suspected. Semi-rigid ureteroscopy with biopsy was performed, and xanthogranulomatous inflammation of the ureter was confirmed on the pathology report.InterventionsAfter right open radical nephrectomy was performed, the final pathology report revealed malakoplakia with xanthogranulomatous pyelonephritis.OutcomesAfter the surgery, she has no longer suffered from urosepsis for 8 months, and there were no adverse event or recurrence noted.LessonsWith this case report, we aim to emphasize that these 2 diseases are not mutually exclusive, but they may exist simultaneously in the same patient.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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