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PubMed1994

[Typhlitis].

Typhlitis, ileocecal syndrome and neutropenic enterocolitis are different terms, of what seems to be a localized infection in the cecal mucosa, caused by Clostridia species. Initially described in neutropenic patients, with leukaemias or after antineoplastic chemotherapy, typhlitis can also occur in HIV patients, as in the present case report. Their early diagnosis is not easy, becoming particularly difficult in immunodepressed patients, whom can be affected by multiple problems causing similar symptoms. Treatment, as well, can be problematic, and aggressive medical treatment should be pursued. If some patients may need surgery, others might be submitted to unnecessary surgical procedures. In the long range, medical control of this situation can be very difficult.

Enterocolitis↗
PubMedDate not supplied

Typhlitis in acute childhood leukemia.

Typhlitis is a necrotizing inflammation of the cecum usually found in acute leukemia patients on chemotherapy in the setting of agranulocytosis. We describe five cases of typhlitis, characterized by fever, abdominal pain, abdominal tenderness and watery diarrhea, occurring during periods of neutropenia. In 4 cases, sonography showed thickening of the cecum wall. Ultrasound appears to offer an easy noninvasive method of diagnosing this potential lethal disease. Four patients were treated successfully with broad-spectrum antibiotics and bowel rest. There was 1 death resulting from septic complication.

Acute Disease↗
PubMed1997

[Typhlitis].

Typhlitis (from Greek, "typhlon", cecum) is an inflammatory process involving the cecum and ascending colon--in neutropenic patients after chemotherapy. Early diagnosis and treatment is of great importance, since the mortality is high. In the past decade there has been an increasing number of reports, as well as impressive improvement in diagnosis, and treatment. We describe 2 patients treated in our department. We emphasize the evolving changes in the management of these patients, from early surgical intervention to conservative treatment, and the problem of prophylactic treatment for those who survive an episode of typhlitis.

Adult↗
PubMed1976

A case of pneumococcal typhlitis.

A 29-year-old man had abdominal pain for 24 hours. This and the results of an abdominal examination were typical of acute appendicitis. He had suffered sinusitis for two weeks. At operation, the appendix was normal; there was an abscess in the cecal wall, the exudate of which grew pneumococci. Incidental appendectomy was done and the patient was treated successfully with lincomycin hydrochloride, and later, cephalexin monohydrate. It is possible that the typhlitis was secondary to the upper respiratory infection.

Adult↗
PubMed1983

Neutropenic typhlitis. A plea for conservatism.

Neutropenic typhlitis is an acute inflammation of the cecum occurring in neutropenic patients. Two cases are described, both presenting typical features of the disease. It is our experience that the treatment approach should consist of bowel rest, fluid therapy, and massive administration of broad spectrum antibiotics. In some cases, full recovery will follow. If abdominal signs persist, surgery should be deferred until hematologic convalescence occurs. At this time, cecostomy and drainage should be adequate. Only in very severe cases, with wide-spread necrosis, should a right hemicolectomy be performed.

Acute Disease↗
PubMed1986

Typhlitis in acute childhood leukaemia: radiological features.

Typhlitis is a necrotising inflammation of the caecum usually found in acute leukaemic patients on chemotherapy. We described the radiological features of two children with this complication. The first was diagnosed by an enema using water-soluble contrast medium and the second by ultrasound and computed tomography (CT). A water-soluble contrast medium enema is considered diagnostic in this clinical context and excludes intussusception and, often, appendicitis. Ultrasound showed a rounded mass with dense central echoes and a wider hypoechoic periphery. Computed tomography showed the long segment of thick-walled ascending colon and caecum; if perforation is suspected, ultrasound and CT might be preferable to a contrast enema.

Cecal Diseases↗
PubMed2002

Typhlitis in an immunocompromised patient.

We report the case of a young man who presented with right lower quadrant pain, while being treated for acute lymphatic leukaemia. Clinical findings were suggestive of appendicitis. Computed tomography scan of the abdomen was done and showed the presence of a neutropenic enterocolitis or typhlitis.

Adult↗
PubMedDate not supplied

Typhlitis due to Balantidium coli in captive lowland gorillas.

Typhlitis caused by Balantidium coli and requiring surgical resection occurred in three captive lowland gorillas over a 30-month period. Not one of the other gorillas in the colony or their keepers was ill. B. coli is distributed widely geographically and widely among mammals. Asymptomatic commensalism predominates, but invasion of the colonic mucosa can produce diarrhea and dysentery and set the stage for local or systemic spread.

Animals↗
PubMedDate not supplied

CT detection of typhlitis.

A case of typhlitis (neutropenic colitis) is reported in which the initial diagnosis was suggested by CT. Radiologists performing CT should be aware of this potentially lethal complication of leukemia, which may appear as a clinically unsuspected finding on CT.

Adult↗
PubMed2001

Foreign matter salpingitis 3 years after typhlitis.

This case suggests that typhlitis may cause delayed abdominal pathology. A history of this condition should be considered in the work-up of any patient with gastrointestinal or genitourinary pathology.

Abdomen, Acute↗
PubMed2003

Analysis of gene expression in ceca of Helicobacter hepaticus-infected A/JCr mice before and after development of typhlitis.

The inflammatory bowel diseases, Crohn's disease and ulcerative colitis, are chronic inflammatory disorders of the gastrointestinal tract. The causes of these diseases remain unknown; however, prevailing theories suggest that chronic intestinal inflammation results from a dysregulated immune response to ubiquitous bacterial antigens. While a substantial body of data has been amassed describing the role of the adaptive immune system in perpetuating and sustaining inflammation, very little is known about the early signals, prior to the development of inflammation, that initiate and direct the abnormal immune response. To this end, we characterized the gene expression profile of A/JCr mice with Helicobacter hepaticus-induced typhlitis at month 1 of infection, prior to the onset of histologic disease, and month 3 of infection, after chronic inflammation is fully established. Analysis of the gene expression in ceca of H. hepaticus infected mice revealed 25 up-regulated and 3 down-regulated genes in the month-1 postinoculation group and 31 up-regulated and 2 down-regulated genes in the month-3 postinoculation group. Among these was a subset of immune-related genes, including interferon-inducible protein 10, monokine induced by gamma interferon, macrophage-induced protein 1 alpha, and serum amyloid A1. Semiquantitative real-time reverse transcriptase PCR confirmed the increased expression levels of these genes, as well as elevated expression of gamma interferon. To our knowledge, this is the first report profiling cecal gene expression in H. hepaticus-infected A/JCr mice. The findings of altered gene expression prior to the development of any features of pathology and the ensuing chronic disease course make this an attractive model for studying early host response to microbe-induced inflammatory bowel disease.

Animals↗
PubMed1998

Typhlitis caused by intestinal Serpulina-like bacteria in domestic guinea pigs (Cavia porcellus).

Between January 1992 and December 1996, Serpulina-like bacteria were demonstrated in intestinal tract lesions from 37 of 88 guinea pigs submitted to the University of Ghent in Ghent, Belgium, for necropsy because of disease and death from different unknown causes. All infected animals had a history of sudden death with minimal introductory clinical signs. Occasionally, they produced yellow, slimy feces or showed nervous signs, but the condition always had a fatal outcome within 24 h. When larger colonies of guinea pigs were involved, the disease spread very rapidly unless treatment with ronidazole was initiated. Lesions consisted of a catarrhal or hemorrhagic inflammation of the colon and cecum (typhlitis). Electron microscopy demonstrated the presence of large numbers of Serpulina-like organisms adhering to the cecal mucosae of these animals. Attempts to isolate the agents failed. The organisms did not stain by an immunofluorescence technique for the detection of Serpulina hyodysenteriae. The present data provide evidence that intestinal Serpulina-like organisms can be important as a cause of disease in guinea pigs.

Animals↗
PubMed1989

Sonographic observations in a patient with typhlitis.

The sonographic findings in a patient with typhlitis are presented. Sonography showed a solid mass with a "target" sign in the right lower quadrant, continuous with the ascending colon. In addition to suggesting the diagnosis, sonography was helpful in the follow-up examination of the patient because it was able to assess the gradual decrease in the thickness of the bowel wall and ultimate resolution of the inflammatory process.

Anemia, Aplastic↗
PubMed1989

Clostridium difficile-associated typhlitis in specific pathogen free guineapigs in the absence of antimicrobial treatment.

Clostridium difficile (toxin) associated typhlitis was diagnosed in untreated barrier-maintained specific pathogen free guineapigs. It resembled the pathological lesions of antibiotic induced enterocolitis. The possible role of limited colonization resistance to C. difficile provided by mouse enteric microflora in the pathogenesis of the disease is discussed.

Animals↗
PubMed2004

Nodular typhlitis associated with the nematodes Heterakis gallinarum and Heterakis isolonche in pheasants: frequency and pathology with evidence of neoplasia.

An investigation related to the frequency and pathology of Heterakis gallinarum and pathology of Heterakis isolonche in pheasants from Rio de Janeiro, Brazil was conducted by means of clinical examinations, necropsies, and histopathological analysis in 50 ring-necked pheasants from backyard flocks of 11 localities; also, histological sections of caeca of golden pheasants deposited in the Helminthological Collection of the Oswaldo Cruz Institute (CHIOC) have been considered in the present study. During necropsies, only specimens of H. gallinarum were recovered with a prevalence of 90%, mean intensity of 81.9 and range of infection of 1-413. Gross lesions were characterized by congestion, thickening, petechial haemorrhages of the mucosa, intussusception, and nodules in the cecal wall. Under microscopy, chronic diffuse typhlitis, haemosiderosis, granulomas with necrotic center in the submucosa and leiomyomas in the submucosa, muscular and serosa associated with immature H. gallinarum worms were observed. The examination of histological sections previously deposited in the CHIOC, revealed more severe alterations associated with concomitant infections with H. gallinarum and H. isolonche in golden pheasants, and were characterized by several necrotic areas with cholesterol clefts in the submucosa, giant cell granulomas in the submucosa, and serosa centralized by necrosis and worm sections and neoplastic nodules in the muscular and submucosa.

Animals↗
PubMed2005

Fibrino-necrotic typhlitis caused by Escherichia fergusonii in ostriches (Struthio camelus).

Two adult ostriches developed anorexia, prostration, and severe hemorrhagic diarrhea, dying 24 hr after the onset of clinical signs. On postmortem examination, the cecal mucosa showed locally extensive areas of hemorrhages and fibrino-necrotic typhlitis with a white-yellowish material covering the mucosal surface. Multiple serosal petequial hemorrhages and fibrinous peritonitis were present. Histologic examination revealed an intense mononuclear infiltration in the lamina propria and submucosa of the cecum and extensive superficial necrosis associated with fibrin and serocellular deposits. Several gram-negative bacterial colonies were observed within the necrotic areas. Samples from intestinal lesions were collected, and pure growth of Escherichia fergusonii was obtained. Escherichia fergusonii is a member of Enterobacteriaceae, closely related to Escherichia coli and Shigella sp., established as a new species of the genus Escherichia in 1985. In veterinary medicine, E. fergusonii has been reported in calves and sheep from dinical cases suggestive of salmonellosis. To our knowledge, this report represents the first description of E. fergusonii associated with enteritis in ostrich.

Animals↗