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PubMedDate not supplied

Successful medical management of neutropenic enterocolitis (typhlitis) in a child with acute lymphoblastic leukemia.

We report a case of acute lymphoblastic leukemia that was complicated by neutropenic enterocolitis (typhlitis) during the initial period of remission-induction chemotherapy. The patient's clinical symptoms resolved after aggressive treatment with intravenous fluids and electrolytes, nasogastric decompression, bowel rest, total parenteral nutrition, broad-spectrum antibiotics, and granulocyte colony-stimulating factor. Netropenic enterocolitis should always be considered in neutropenic leukemic children with the triad of fever, vomiting, and abdominal pain. Gastrointestinal hemorrhage may also accompany the symptoms described above. Plain roentgenogram, ultrasonography and computed tomography of the abdomen are helpful for making the diagnosis of this clinical condition. Early recognition and proper medical management of neutropenic enterocolitis may prevent the need for surgical intervention, and/or be life-saving.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Typhlitis occurring in autologous bone marrow transplantation.

A case of typhlitis which complicated the course of autologous bone marrow transplantation (ABMT) is reported. It is the first report of such a life-threatening complication in the setting of ABMT. Conservative treatment without surgical intervention may offer the best results.

Acinetobacter Infections↗
PubMed1987

Rapid diagnosis of neutropenic enterocolitis (typhlitis) by ultrasonography.

Neutropenic enterocolitis (also termed typhlitis) is an acute necrotizing process involving segments of the large and small intestine that occurs in the setting of agranulocytosis, most commonly in patients with acute leukemia. Rapid diagnosis and treatment is necessary for survival. We present a patient in whom abdominal ultrasonography revealed evidence of bowel wall thickening and ascites, confirming the diagnosis of neutropenic enterocolitis. Sonography offers a rapid, safe, and noninvasive means of diagnosis for this condition.

Agranulocytosis↗
PubMed1994

[Neutropenic typhlitis: a frequently missed complication of aplasia-inducing tumor therapy with a possible association to the combination of etoposide with high-dose cytosine-arabinoside].

Neutropenic typhlitis (NPT) was observed in 4 of 5 adult patients with acute leukemia treated with etoposide (VP16; 100 mg/m2/d for 6 days) and high-dose cytosine-arabinoside (HD ARAC, 2 g/m2 twice daily for 6 days) in a period of 11 months. One additional patient developed NPT after combination therapy with amsacrine (mAMSA, 120 mg/m2/d for 5 days) and etoposide (80 mg/m2/d for 5 days) during the same period. These 5 cases of NPT meant a drastic rise in the incidence of NPT at our institution, where a careful retrospective review of the charts of the 128 adult patients with leukemia treated during the preceding 5 years revealed only one case of NPT. Nonsurgical treatment led to recovery in all cases. No recurrence of NPT was observed during 3 further courses of aplasia with the use of selective (2 patients) or complete (1 patient) bowel decontamination. Etoposide may potentiate the gastrointestinal toxicity of high-dose cytosine-arabinoside with a higher incidence of NPT.

Acute Disease↗
PubMedDate not supplied

Cases of spirochete-associated necrotizing typhlitis in captive common rheas (Rhea americana).

Ceca from greater or common rheas (Rhea americana) with gastrointestinal disease were collected from diagnostic labs and avian pathologists across the United States. The ceca were evaluated for the presence of spirochetes and necrosis using hematoxylin and eosin stain or Warthin-Starry silver-stained tissue sections and anaerobic culture. Spirochete-associated necrotizing typhlitis was documented in 11 states. Most cases were reported in the summer and fall and occurred in rheas less than 5 mo of age. Spirochetes isolated from ceca with necrosis were either strongly or weakly beta-hemolytic. All spirochetes isolated from ceca without necrosis were weakly beta-hemolytic. Rheas might be host to both pathogenic and nonpathogenic spirochetes.

Age Factors↗