Weisenburger D D, Vinh T N, Levinson B
Clin Orthop Relat Res. 1985 Dec(201):106-10.
Malakoplakia is a distinctive type of histiocytic inflammatory reaction that occurs most commonly in the urinary tract and is usually due to infection by coliform bacteria. A 68-year-old woman developed a pathologic fracture of the right femoral neck secondary to malakoplakia of bone. The patient had received multiagent chemotherapy for a malignant lymphoma prior to the development of malakoplakia. Chemotherapy-related leukopenia and hypogammaglobulinemia resulted in Escherichia coli cystitis and sepsis. Bacterial cultures of tissue from the femoral fracture site also grew E. coli. Presumably, hematogenous spread of the bacteria led to infection of the femoral neck. Prosthetic repair of the fracture and antibiotic therapy resulted in a good clinical response. This is the third case of malakoplakia involving bone that appears to have been reported in the literature. Malakoplakia should be considered in the differential diagnosis of lytic bone lesions that occur in immunosuppressed patients.
软斑病是一种独特的组织细胞性炎症反应，最常见于泌尿系统，通常由大肠埃希菌感染引起。一名68岁女性因骨软斑病继发右股骨颈病理性骨折。该患者在发生软斑病之前曾接受多药化疗治疗恶性淋巴瘤。化疗相关的白细胞减少和低丙种球蛋白血症导致大肠杆菌膀胱炎和败血症。股骨骨折部位组织的细菌培养也培养出大肠杆菌。据推测，细菌的血行播散导致了股骨颈感染。骨折的假体修复和抗生素治疗取得了良好的临床反应。这是文献中报道的第三例累及骨骼的软斑病病例。在免疫抑制患者发生的溶骨性骨病变的鉴别诊断中应考虑软斑病。
