Malakoplakia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Malakoplakia?
An infectious disease doctor, a doctor who treats infections, often helps manage malakoplakia. A urologist, a urinary system doctor, or a gastroenterologist, a digestive system doctor, may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is malakoplakia?
Malakoplakia is a rare, long-lasting inflammatory disease. It causes soft plaques, which are raised patches, on organs of the body. It is also spelled malacoplakia.
It most often affects the urinary system and reproductive organs. It can also affect the pelvis, bones, lungs, thyroid gland, digestive tract, skin, and kidneys. It is listed as starting in adulthood.
Symptoms
Symptoms depend on which part of the body is affected. Signs can include:
- Urinary symptoms, which are problems with passing urine.
- Blood in the stool.
- Skin lesions, which are changes in the skin.
On the skin, it may look like a rash with small, itchy, red patches. The patches may be painful or filled with fluid.
Malakoplakia can look different from person to person. This can delay the diagnosis.
Causes and who gets it
The cause is not well understood. Doctors think it is linked to a problem with macrophages. These are immune cells that respond to bacteria. In malakoplakia, they do not clear some bacteria well.
Malakoplakia is most often caused by E. coli bacteria. Klebsiella and Proteus bacteria are also named as causes.
People with a weakened immune system have a higher risk. Examples are HIV or AIDS, an organ transplant, cancer, poorly controlled diabetes, and autoimmune disorders. The disease is rare.
How doctors diagnose it
Malakoplakia can be hard to find. It can look like cancer, sarcoidosis, tuberculosis, Crohn disease, fungal infections, and histiocytic disorders. Doctors may study a tissue sample under a microscope. This can help with diagnosis, but it is not always needed, especially early in the disease.
No standard guidelines exist for diagnosis or treatment because the disease is so rare.
Treatment
Treatment often involves a long course of antibiotics, which are medicines that kill bacteria. Surgery to remove the affected tissue may also be needed. Some people take medicines that weaken the immune system. Doctors may stop these when appropriate. Follow your doctor's instructions and do not stop any medicine on your own.
Care often involves a team of doctors from different fields.
When to see a doctor
See a doctor if you have urinary symptoms, blood in your stool, or painful or fluid-filled skin patches, especially if your immune system is weak. Call 911 or go to the emergency room if you have severe belly pain or pressure, fainting, trouble breathing, or a sudden change in thinking or behavior.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your symptoms and health history, order first tests, and help coordinate care among specialists. They can also help you keep up with long-term follow-up.
Common questions
Is malakoplakia cancer?
No. Malakoplakia is a rare chronic inflammatory disease. It can look like cancer, so doctors check for other conditions too.
Which bacteria cause malakoplakia?
Malakoplakia is most often caused by E. coli bacteria. Klebsiella and Proteus bacteria are also named as causes.
Who is most likely to get malakoplakia?
People with a weakened immune system are most likely to get it. Examples include people with HIV or AIDS, organ transplants, cancer, poorly controlled diabetes, or autoimmune disorders.
Why is malakoplakia hard to diagnose?
It can look different from person to person, and it can look like other conditions. Doctors may first think of cancer, sarcoidosis, tuberculosis, or Crohn disease. This can delay the diagnosis.
How is malakoplakia treated?
Treatment often involves a long course of antibiotics. Some people also need surgery to remove affected tissue. Doctors may stop medicines that weaken the immune system when appropriate.
Sources
- NIH Genetic and Rare Diseases Information Center - Malakoplakia
- PubMed Central - Malakoplakia of the small intestine presenting as an abdominal mass
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
