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Renal Malakoplakia: A Diagnostic Challenge Presenting as a Subcapsular Collection despite Clinical Recovery

Published on: 9th April, 2026

Background: Renal malakoplakia is a rare chronic granulomatous inflammatory disorder characterized by defective macrophage function. It typically occurs in immunocompromised patients with recurrent urinary tract infections. We present a case of renal malakoplakia in a diabetic patient who progressed to nephrectomy despite initial conservative management.Case presentation: A 57-year-old female patient with a medical history of insulin-dependent type 2 diabetes mellitus was admitted to the hospital with symptoms including fever, left flank pain, and dysuria. A physical examination revealed a tender left lumbar mass. Laboratory investigations revealed a leukocytosis (16,500/mm³), elevated C-reactive protein (142 mg/L), and preserved renal function. A urine culture revealed the presence of multidrug-resistant Escherichia coli (>106CFU/mL). A subsequent Computed Tomography (CT) scan revealed an enlarged left kidney with a 9 × 6 cm multiloculated subcapsular collection, causing significant parenchymal compression, along with two non-obstructive inferior pole calculi. The initial management strategy encompassed ultrasound-guided percutaneous drainage and targeted antibiotic therapy, with the latter being contingent upon bacterial sensitivities. Notwithstanding the patient’s positive clinical recovery, Technetium-99m Dimercaptosuccinic Acid ((99m)Tc-DMSA) renal scintigraphy performed four weeks after the episode revealed a non-functional left kidney, exhibiting a 15% differential function. Following a multidisciplinary discussion, a total left nephrectomy was performed. A histopathological examination revealed extensive replacement of renal parenchyma by polymorphous inflammatory infiltrate with pathognomonic Michaelis-Gutmann bodies. These bodies are spherical, basophilic, perinuclear inclusions that demonstrate strong positivity for Periodic Acid-Schiff and Perls stains. The postoperative course was complicated by self-limited lymphorrhage. At the 3-month follow-up, the patient reported complete resolution of symptoms and remains under nephrological surveillance.Conclusion: This case underscores the diagnostic challenges posed by renal malakoplakia, a condition that can present with a wide spectrum of mimics, including infectious and neoplastic processes. Early diagnosis and prolonged antibiotic therapy with agents capable of intracellular penetration may preserve renal function; however, nephrectomy remains necessary when irreversible parenchymal damage has occurred. Diabetes mellitus has been identified as a significant risk factor for malakoplakia development through impaired leukocyte function. 
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Stone on the Mesh: Intravesical Erosion after Laparoscopic Promontofixation-A Hidden Cost of Durability

Published on: 19th February, 2026

Intravaginal erosion of synthetic mesh after laparoscopic promontofixation(sacrocolpopexy) is an uncommon but clinically relevant late complication. When mesh becomes exposed within the bladder, it may function as a persistent foreign body, encouraging chronic inflammation, bacterial colonization, recurrent lower urinary tract symptoms, and progressive encrustation that can culminate in bladder stone formation. We report a 60-year-old woman with a history of laparoscopic promontofixation using standard polypropylene mesh performed approximately five years earlier. She presented with progressive urinary symptoms. Bladder ultrasound demonstrated an intravesical calculus, and diagnostic cystoscopy confirmed a bladder stone developing on exposed intravesical mesh fibers, consistent with intravesical mesh erosion. Endoscopic management was performed with cystolithotripsy followed by section/resection and removal of the exposed intravesical mesh to eliminate the lithogenic nidus, with a favorable outcome. In women with prior promontofixation presenting with bladder stones, recurrent urinary tract infections, hematuria, or persistent irritative urinary symptoms, intravesical mesh erosion must be considered. Cystoscopy is essential for diagnosis because imaging may identify the stone but not the underlying foreign-body etiology, and definitive treatment requires both stone clearance and elimination of intravesical foreign material to prevent recurrence.
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Adult Bladder Exstrophy with Premalignant Changes Following Failed Reconstruction: A Case Report

Published on: 1st April, 2026

Background: Bladder exstrophy is a rare congenital abnormality that is usually managed with multiple surgical interventions. Long-term consequences include recurrent urinary tract infections, bladder stones, fistulae, and metaplastic changes with malignant potential.Case Presentation: We present a case of a 21-year-old male with a history of failed childhood surgeries for bladder exstrophy who presented with a vesicocutaneous fistula and a 7 cm bladder stone. He underwent an open cystolithotomy with bladder augmentation and creation of a Benchekroun continent valve. However, the patient developed recurrent fistulae due to poor tissue quality. Histopathological examination confirmed early squamous metaplasia in the bladder mucosa. After discussion in a multidisciplinary meeting, the patient underwent a radical cystectomy with ileal conduit urinary diversion using the Bricker technique. He is doing well at 3 months with no evidence of any complication.Conclusion: This case illustrates the difficulties encountered in managing adult patients with bladder exstrophy and failed reconstructions. The presence of squamous metaplasia, poor bladder tissue, and recurrent complications all contributed to the decision for radical cystectomy. It is important to recognize these changes and address them appropriately in a timely manner to prevent further complications and possible malignant changes.
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Application of In vitro Reconstructed 3D Biomimetic Tumor Microenvironment Models in Cancer Research

Published on: 8th June, 2026

Cancer is a highly heterogeneous and dynamic disease whose progression, metastasis, therapeutic resistance, and immune escape are strongly regulated by the tumor microenvironment (TME). However, conventional two-dimensional (2D) cell culture systems and animal models often fail to recapitulate the structural organization, multicellular interactions, biochemical gradients, and mechanical properties of native tumors, thereby limiting the translational efficiency of preclinical cancer research and drug development. In recent years, in vitro three-dimensional (3D) biomimetic tumor models-including tumor spheroids, tumor organoids, and tumor-on-a-chip systems—have emerged as powerful platforms for reconstructing physiologically relevant tumor microenvironments and investigating complex tumor behaviors.In this review, we systematically summarize the construction principles, biological characteristics, advantages, and limitations of major 3D biomimetic tumor models. We further discuss their recent applications in drug screening, precision medicine, tumor heterogeneity research, cancer stem cell investigation, metastasis, therapeutic resistance, and immunotherapy evaluation. Particular emphasis is placed on the comparative advantages of different 3D systems in modeling dynamic tumor–microenvironment interactions and supporting translational oncology research. Additionally, we will discuss the current problems of vascularisation, extracellular matrix biomimetics, experimental reproducibility, standardisation, and large-scale clinical translation. Finally, we present some new directions for future work, including three-dimensional bioprinting, multi-omics technology, artificial intelligence, and multi-organ-on-a-chip platforms, which may further improve the physiological relevance and predictive power of next-generation tumor models.In short, this review has listed the current progress of 3D biomimetic tumour modelling and discussed some prospects for its use in mechanistic studies of cancer, drug discovery, etc.
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Bilateral Severe Encrustation of Long-Term Indwelling Double-J Stents in a Young Non-Lithiasic Patient

Published on: 16th March, 2026

Ureteral double-J stents are a commonly used device in urological practice to allow urinary drainage, avoid ureteral obstruction processes, and protect the upper urinary tract after surgical procedures. However, long indwelling time may give rise to numerous complications, such as infection, migration, and fragmentation of the stent, especially encrustation. Encrustation of stents is a well-known complication that has been closely related to the time active of the stent and can cause significant morbidity if not timely addressed. In severe cases, abundant mineral deposition can result in the development of large calculi encasing the stent and rarely progress to staghorn stones. These cases may pose challenges in terms of the extraction of the stent and may result in complex endourological intervention. The encrustation likelihood is substantially higher if stents are left forgotten or remain in place longer than the advised period. Most patients with heavily encrusted stents have symptoms including flank pain, urinary tract infection, hematuria, or obstructive uropathy, but can present without any symptoms, and this can delay the diagnosis.
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Human Poxvirus Infections: Epidemiology, Transmission, and Clinical Features of Major Orthopoxvirus Diseases

Published on: 17th June, 2026

Poxviruses are big, double-stranded DNA viruses that can infect a variety of animal hosts, including humans. Other clinically significant poxvirus infections, such as monkeypox (mpox), cowpox, and molluscum contagiosum, continue to present new and re-emerging public health issues even after smallpox was eradicated. The epidemiology, transmission dynamics, clinical manifestations, diagnostic methods, and treatment approaches of the four main human poxvirus infections are all covered in this study’s methodical narrative synthesis.Relevant studies published between 2000 and 2025 were found by a systematic search of PubMed, Scopus, and Google Scholar; 34 of them were included in the final analysis. Results show that poxviruses differ significantly in host range, transmission patterns, and disease severity, despite sharing common biological traits including cytoplasmic replication and distinctive cutaneous lesion progression. While mpox has resurfaced worldwide, exhibiting persistent human-to-human transmission during the 2022–2023 outbreak, smallpox is still historically relevant because of its high fatality and successful eradication. Cowpox is still an uncommon zoonotic disease associated with animal reservoirs, while Molluscum contagiosum is still very common, especially in children and immunocompromised people. Antiviral medications like tecovirimat offer treatment options for severe cases, and advances in molecular diagnostics, especially polymerase chain reaction, have improved detection.The impact of dwindling population immunity and growing human-animal interaction is demonstrated by the resurgence and persistence of poxvirus diseases. To reduce future epidemics, more surveillance, better diagnostic capabilities, and integrated One Health policies are crucial.
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Occurrence, Risk Factors, and Clinical Implications of Malaria–typhoid Co-infection among Febrile Patients Attending Camrail Medical Center, Douala, Cameroon

Published on: 4th June, 2026

Background: Malaria and typhoid fever remain major public health problems and important causes of febrile illness in sub-Saharan Africa, particularly in urban settings characterized by poor sanitation, unsafe water supply, overcrowding, and persistent malaria transmission. The clinical manifestations of both diseases frequently overlap, making accurate diagnosis difficult and often leading to empirical treatment, inappropriate antimicrobial use, and delayed patient management. This study assessed the occurrence, associated risk factors, and clinical implications of malaria–typhoid co-infection among febrile patients attending the Camrail Medical Center in Douala, Cameroon. Methods: A hospital-based analytical cross-sectional study was conducted among 220 febrile patients recruited systematically at the outpatient department. Data were collected using structured questionnaires, clinical assessment forms, and laboratory investigations. Malaria infection was diagnosed using standard parasitological methods, while typhoid fever was assessed using routine laboratory procedures. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression in SPSS version 25. Results: Malaria mono-infection accounted for 31.8% of cases, typhoid mono-infection for 10.9%, and malaria–typhoid co-infection for 15.5%, whereas 41.8% of participants had neither infection. Significant predictors of co-infection included unsafe water sources (AOR = 3.12; p = 0.001), poor food hygiene (AOR = 3.85; p < 0.001), non-use of bed nets (AOR = 2.21; p = 0.021), and exposure to stagnant water (AOR = 2.76; p = 0.004). Co-infected patients experienced significantly more severe clinical manifestations, including high fever, vomiting, diarrhea, abdominal pain, and headache. Age-stratified analysis showed a higher proportion of co-infection among participants aged ≤25 years (18.8%) compared with those aged ≥26 years (12.9%), although the difference was not statistically significant (p = 0.194). Gender-based analysis demonstrated no significant association between sex and infection category (p = 0.606).Conclusion and recommendations: Malaria–typhoid co-infection remains a significant public health concern in Douala. Integrated diagnostic approaches, improved environmental sanitation, safe water access, food hygiene promotion, and strengthened malaria prevention measures are essential to reducing the burden of co-infection and limiting inappropriate antimicrobial use.
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat
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