Gallium scan in the diagnosis and treatment of renal malacoplakia.

A middle-aged female was admitted with a presumptive diagnosis of pyelonephritis that failed to respond to conventional antibiotic therapy. Multiple investigations to define the etiology of the persistent fever and accompanying acute renal failure were negative. A gallium scan revealed intense uptake in the renal parenchyma. Percutaneous renal biopsy revealed malacoplakia. Six weeks of therapy with ciprofloxacin resulted in resolution of fever, improvement in the follow-up gallium scan, and reversal of the acute renal failure.