II. Epidemiology

  1. Rare

III. Pathophysiology

  1. Secondary Granulomatous inflammatory reaction to chronic genitourinary infection in Immunocompromised patients
  2. Associated with chronic infections (e.g. E. coli and other Gram Negatives)
  3. Infections may involve the Kidney and Retroperitoneum, Bladder, Prostate, ureter, Kidney, and female genital tract

IV. Labs

  1. Hallmark finding is foamy histiocytes with Basophilic inclusions (Michaelis-Gutmann bodies)

V. Management

  1. Treated with antibiotics and surgical excision, correction of Immunosuppression
  2. Antibiotic management with Ciprofloxacin or trimethoprim-sulfamethoxazole
  3. Concurrent management with Bethanechol chloride which improves antibiotic efficacy

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