Severe Ulcerative Colitis Complicated by Malakoplakia Resulting in Proctocolectomy.

We report a 45-year-old man with medically refractory ulcerative colitis with superimposed colonic malakoplakia, presumed related to chronic use of azathioprine and biologics. This is the first reported case of malakoplakia in a patient requiring high doses of combination therapy. Treatment of malakoplakia is not standardized, but can involve systemic antibiotics, or surgical resection, which in this case resulted in proctocolectomy.