Background: Malakoplakia is a rare complication of E. coli infection, rarely seen with other infections in immunocompromised patients. Aim: This case highlights a rare case of Malakoplakia. It should be considered in immunocompromised patients with gastrointestinal/genitourinary symptoms, and abdominal lymphadenopathy. Case: We present a case with Achromobacter sepsis from an unknown source. Upon imaging, nonspecific mesenteric lymphadenopathy and colon changes prompted a colonoscopy and node biopsy, leading to the current diagnosis. Conclusion: Nonspecific gastrointestinal symptoms in immunocompromised patients should be explored for uncommon causes. Exploration includes obtaining imaging, performing colonoscopy, and taking biopsies. Malakoplakia is one such rare cause that is seldom considered and particulars of diagnosis and treatment are still unclear.
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