Colonic malacoplakia and abdominal tuberculosis in a child

A 41/2-year-old girl had colonic malacoplakia of two years' duration, the presenting symptom being rectal bleeding. Abdominal tuberculosis andEscherichia coli lumbar abscess were diagnosed at the age of 31/2 years. Despite antituberculous treatment, there was no improvement and she died from protein-losing enteropathy. The patient is discussed and the literature reviewed, with special emphasis on the incidence of malacoplakia in children, the aggressive nature of colonic malacoplakia, and the lack of response to treatment. A brief review of the pathogenesis of malacoplakia is considered.