Soo Jin Jung, et al: Malakoplakia of the Kidney in a Patient with Secondary Adrenal Insufficiency Table 2. Results of low dose adrenocorticotropic hormone stimulation Test on the third day of hospitalization. Hormone Cortisol* (µg/dL) Level at 0 min 8.56 Level at 15 min 11.9 Level at 30 min 13.9 Level at 60 min 13.9 *Reference range: 7.00-19.4 in the morning, 2.00-9.00 in the afternoon. Figure 1. Abdomen-pelvic computed tomography (CT) scan. An abdomen-pelvic CT image obtained on the second day after admission (A) shows an ill-deﬁned inﬂammatory lesion in the left kidney with multifocal abscess pockets in the left perirenal space, extending to the descending colon. An abdomen-pelvic CT image obtained after 4 months during readmission (B) shows the remaining ill-deﬁned inﬂammatory lesion in the left kidney and descending colon involvement. (5 mg, 2.5 mg two times a day) of prednisolone acetate. However, the patient complained of myalgia, which was accompanied with leukocytosis (white blood cell count 13,650 μg/L [neutrophil 84.9 %]). Radiological reading of the abdomen-pelvic CT conducted on the second day after admission showed that there was an ill- defined inflammatory lesion with multifocal abscess pockets in the left perirenal space, which was suspected of actinomycosis of the descending colon, extended to the left kidney (Figure 1A). Compared to the abdomen-pelvic CT finding performed outside, the lesion seemed to have decreased slightly in size. Urinalysis was repeated and showed many white blood cells per high-power field and yeast-like organisms, which was confirmed as yeast in the Korean J Fam Med Vol. 32, No. 6 Sep 2011 | 369