519 results match your criteria Neutropenic Enterocolitis


Safety and risk of febrile recurrence after early antibiotic discontinuation in high-risk neutropenic patients with haematological malignancies: a multicentre observational study.

J Antimicrob Chemother 2022 Jun 24. Epub 2022 Jun 24.

Department of Infectious Diseases, University Hospital of Nantes and CIC 1413, Nantes, France.

Background: Early antibiotic discontinuation according to the Fourth European Conference on Infections in Leukaemia (ECIL-4) recommendations is not systematically applied in high-risk neutropenic patients with haematological malignancies.

Methods: A retrospective multicentre observational study was conducted over 2 years to evaluate the safety of early antibiotic discontinuation for fever of unknown origin (FUO) during neutropenia after induction chemotherapy or HSCT, in comparison with a historical cohort. We used Cox proportional hazards models, censored on neutropenia resolution, to analyse factors associated with febrile recurrence. Read More

View Article and Full-Text PDF

[Neutropenic enterocolitis in the pediatric cancer patient].

Rev Chilena Infectol 2022 02;39(1):59-69

Hospital Clínico San Borja Arriarán, Chile.

Neutropenic enterocolitis (NEC) is a heterogeneous disease of the gastrointestinal tract with systemic response, that corresponds to a severe and life-threatening clinical condition in immunocompromised patients, especially in childhood cancer. The pathologic features are poorly understood, although its multifactorial cause of NEC is well established and it is associated with the cytotoxic effects of the chemotherapy agents used and recognized by the classic triad of fever, neutropenia, and abdominal pain, secondary to gastrointestinal injuries that alters mucosal permeability and helps intramural bacterial invasion. NEC is truly a clinical challenge that requires an early diagnosis and a multidisciplinary approach including basic laboratory and imagological tests in high complexity centers. Read More

View Article and Full-Text PDF
February 2022

Neutropenic Enterocolitis as a Complication of Autologous Stem Cell Transplant in Patients With Multiple Myeloma: A Case Series.

Cureus 2022 Apr 25;14(4):e24475. Epub 2022 Apr 25.

Department of Hematology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.

Neutropenic enterocolitis (NE) is a rare but severe complication occurring in neutropenic patients undergoing intensive chemotherapy. Mortality is high, so early diagnosis is required to start urgent medical or surgical treatment. Data analysis of the development of NE after hematopoietic stem cell transplantation remains scarce. Read More

View Article and Full-Text PDF

Gastrointestinal Manifestations of Immunodeficiency: Imaging Spectrum.

Radiographics 2022 May-Jun;42(3):759-777. Epub 2022 Apr 22.

From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.I., V.M.M.); Department of Radiology, University of Louisville, Louisville, Ky (N.K.); Department of Radiology, VA Medical Center, Fayetteville, NC (A.R.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (M.G.L.); Department of Radiology, Division of Abdominal Imaging, University of Pittsburgh Medical Center, Pittsburgh, Pa (A.K.D.); Department of Radiology, University of Texas Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 (L.K., V.S.K.); and Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (S.R.P.).

There is a wide spectrum of hereditary and acquired immunodeficiency disorders that are characterized by specific abnormalities involving a plethora of humoral, cellular, and phagocytic immunologic pathways. These include distinctive primary immunodeficiency syndromes due to characteristic genetic defects and secondary immunodeficiency syndromes, such as AIDS from HIV infection and therapy-related immunosuppression in patients with cancers or a solid organ or stem cell transplant. The gut mucosa and gut-associated lymphoid tissue (the largest lymphoid organ in the body), along with diverse commensal microbiota, play complex and critical roles in development and modulation of the immune system. Read More

View Article and Full-Text PDF

Outcome and Determinants of Neutropenic Enterocolitis in Pediatric Cancer Patients.

J Pediatr Hematol Oncol 2022 Apr 22. Epub 2022 Apr 22.

Division of Pediatric Oncology, Department of Pediatrics.

Background: Neutropenic enterocolitis (NEC) is a dreaded complication of chemotherapy. There is scant literature regarding incidence, clinical features, and determinants. The understanding of gut dysbiosis in NEC and pediatric cancer is evolving. Read More

View Article and Full-Text PDF

Diagnosis and Management of Typhlitis and Neutropenic Enterocolitis in Children with Cancer.

Pediatr Infect Dis J 2022 Apr 13. Epub 2022 Apr 13.

Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee.

View Article and Full-Text PDF

A Pilot Randomised Controlled Trial Examining the Benefit of a Neutropenic Diet for Children Undergoing Cancer Treatment.

Nutr Cancer 2022 Feb 26:1-7. Epub 2022 Feb 26.

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

Neutropenic diet(ND) has been hypothesized to decrease the rate of febrile neutropenia(FN) occurring post-chemotherapy for pediatric cancers. Despite widespread use, it has not shown to be of benefit by randomized controlled trials(RCT) in western countries. No RCT has been conducted in India/LMIC to evaluate its efficacy against the standard Indian diet. Read More

View Article and Full-Text PDF
February 2022

Recent advances in neutropenic enterocolitis: Insights into the role of gut microbiota.

Blood Rev 2022 Jul 14;54:100944. Epub 2022 Feb 14.

Intensive Care Unit, Saint Louis Academic Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France. Electronic address:

Neutropenic enterocolitis (NE) is a life-threatening complication associated with neutropenia and the main cause of acute abdominal syndrome in neutropenic patients, especially those receiving intensive chemotherapy. This review aims to delineate actual insights into this clinical entity, to emphasize diagnostic and therapeutic management, and to generate hypotheses on pathophysiology to identify avenues for research. Diagnosis is based on the association of neutropenia, fever, abdominal symptoms, and radiologic bowel wall thickening. Read More

View Article and Full-Text PDF

Case reports of invasive mucormycosis associated neutropenic enterocolitis in leukemic children: diagnostic and treatment challenges and review of literature.

BMC Infect Dis 2021 Dec 20;21(1):1268. Epub 2021 Dec 20.

Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran.

Background: Bacterial enterocolitis is one of the most common neutropenic fever complications during intensive chemotherapy. Despite aggressive antibacterial treatments, this complication usually imposes high morbidity and mortality in cancer patients. Management of bacterial neutropenic enterocolitis are well known; however, management of fungal neutropenic enterocolitis may be more challenging and needs to be investigated. Read More

View Article and Full-Text PDF
December 2021

Taxane-Induced Upper Gastrointestinal Bleeding.

Case Rep Oncol 2021 Sep-Dec;14(3):1373-1379. Epub 2021 Sep 21.

Division of Gastrointestinal and Liver Disease, Department of Internal Medicine, University of Southern California ‒ Keck School of Medicine, Los Angeles, California, USA.

Docetaxel is a taxane, which is a class of chemotherapy agent used in the treatment of multiple malignancies. It is known to have gastrointestinal side effects which can range from mild symptoms such as nausea and diarrhea to more severe complications such as neutropenic enterocolitis. In the current literature, taxanes have not been described to cause upper gastrointestinal bleeding and melena. Read More

View Article and Full-Text PDF
September 2021

sQuiz your knowledge! Three violet plaques in an immunocompromised patient.

Eur J Dermatol 2021 Aug;31(4):595-597

Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal, Faculty of Medicine, Dermatology University Clinic, University of Lisbon, Lisbon, Portugal.

View Article and Full-Text PDF

A surgeon's predicament: Clinical predictors of surgery and mortality in neutropenic enterocolitis.

J Pediatr Surg 2022 Mar 4;57(3):443-449. Epub 2021 Sep 4.

Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO, United States; Department of Surgery, University of Colorado School of Medicine, Aurora, CO, United States.

Background: Neutropenic enterocolitis is uncommon but potentially life-threatening, with the cornerstone of treatment being medical management (MM), and surgical intervention reserved for clinical deterioration or bowel perforation. We hypothesized that the Shock Index Pediatric Age-Adjusted (SIPA) is elevated in patients who are at greatest risk for surgical intervention and mortality. We also sought to identify computed tomography (CT) findings associated with surgical intervention and mortality. Read More

View Article and Full-Text PDF

Abdominal Pain in the Immunocompromised Patient.

Emerg Med Clin North Am 2021 Nov 10;39(4):807-820. Epub 2021 Sep 10.

Department of Emergency Medicine, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA 70121, USA.

Abdominal pain in an immunocompromised patient represents a common clinical scenario that may have uncommon causes. Evaluation relies first on identifying the immunocompromise, whether due to congenital immunodeficiencies, malignancy, hematopoietic stem cell transplant, solid organ transplant, or human immunodeficiency virus/acquired immunodeficiency syndrome. Based on this determination, the emergency physician may then build a focused differential of pathophysiologic possibilities. Read More

View Article and Full-Text PDF
November 2021

Early Diagnosis of Neutropenic Enterocolitis by Bedside Ultrasound in Hematological Malignancies: A Prospective Study.

J Clin Med 2021 Sep 21;10(18). Epub 2021 Sep 21.

Bone Marrow Transplant Unit, Department of Clinical and Experimental Medicine, UO Hematology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, 56126 Pisa, Italy.

(1) Background: Neutropenic enterocolitis (NEC) is a life-threatening complication following chemotherapy with high mortality rates. Early diagnosis is crucial to improve outcomes. We designed a large prospective study employing bedside ultrasonography (US) as a novel approach to allow early diagnosis and prompt treatment to reduce mortality. Read More

View Article and Full-Text PDF
September 2021

Neutropaenic enterocolitis: A medical/surgical oncological dilemma.

Afr J Paediatr Surg 2021 Jul-Sep;18(3):171-173

Department of Paediatric Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

Neutropaenic enterocolitis (NE) is a life-threatening condition characterised by an inflammation of the colon and/or the small bowel in the background of chemotherapy-induced neutropaenia. A 16-year-old girl with acute myeloblastic leukaemia (AML) developed fever, right-sided abdominal pain and tenderness with severe neutropaenia. Initial ultrasound findings suggested acute appendicitis for which she had surgery. Read More

View Article and Full-Text PDF

Typhlitis: A Rare Appendicitis Mimic in a Young Healthy Female.

Cureus 2021 Jun 22;13(6):e15839. Epub 2021 Jun 22.

Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, USA.

Typhlitis, also known as neutropenic enterocolitis, is a rare but serious condition characterized by inflammation of the cecum causing right lower quadrant (RLQ) pain and fever. It typically affects immunocompromised patients with neutropenia, hematologic malignancies, AIDS, or those on immunosuppressive therapy. This is an entity that should be considered in any differential for a patient with febrile RLQ pain, not just those with obvious immunosuppression. Read More

View Article and Full-Text PDF

Meropenem-Resistant Achromobacter xylosoxidans, Subspecies Denitrificans Bacteremia in a Patient With Stage IV Adenocarcinoma of the Lung.

Cureus 2021 Jun 9;13(6):e15546. Epub 2021 Jun 9.

Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA.

,subspecie is a rare Gram-negative bacillus that causes health care associated infections in immunocompromised hosts. Carbapenems and anti-pseudomonal penicillins are listed as suitable empiric therapy in the literature. Herein, we report a case of a 77-year-old male with stage IV adenocarcinoma of the lung who presented with and was improving from enterocolitis, only to subsequently develop ,subspeciesbacteremia that was resistant to both meropenem and piperacillin-tazobactam. Read More

View Article and Full-Text PDF

Neutropenic Enterocolitis and Sepsis: Towards the Definition of a Pathologic Profile.

Medicina (Kaunas) 2021 Jun 20;57(6). Epub 2021 Jun 20.

Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Ospedale Colonnello D'Avanzo, Viale Europa 12, 71100 Foggia, Italy.

Neutropenic enterocolitis (NE), which in the past was also known as typhlitis or ileocecal syndrome for the segment of the gastrointestinal tract most affected, is a nosological entity that is difficult to diagnose and whose pathogenesis is not fully known to date. Initially described in pediatric patients with leukemic diseases, it has been gradually reported in adults with hematological malignancies and non-hematological conditions, such as leukemia, lymphoma, multiple myeloma, aplastic anemia, and also myelodysplastic syndromes, as well as being associated with other immunosuppressive causes such as AIDS treatment, therapy for solid tumors, and organ transplantation. Therefore, it is associated with high mortality due to the rapid evolution in worse clinical pictures: rapid progression to ischemia, necrosis, hemorrhage, perforation, multisystem organ failure, and sepsis. Read More

View Article and Full-Text PDF

typhlitis in a patient with acute myelogenous leukemia.

Clin Case Rep 2021 Jun 24;9(6):e04290. Epub 2021 Jun 24.

Division of Hematology/Oncology Department of Internal Medicine University of Cincinnati Cincinnati OH USA.

While patients undergoing treatment for hematologic malignancies are at risk for a variety of infections, gastrointestinal mucormycosis is a rare and feared complication. Diagnosis requires a high index of suspicion and timely evaluation. Prompt treatment improves patient outcomes. Read More

View Article and Full-Text PDF

Typhlitis induced by Histomonas meleagridis affects relative but not the absolute Escherichia coli counts and invasion in the gut in turkeys.

Vet Res 2021 Jun 22;52(1):92. Epub 2021 Jun 22.

Clinic for Poultry and Fish Medicine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria.

Unlike in chickens, dynamics of the gut microbiome in turkeys is limitedly understood and no data were yet published in context of pathological changes following experimental infection. Thus, the impact of Histomonas meleagridis-associated inflammatory changes in the caecal microbiome, especially the Escherichia coli population and their caecal wall invasion in turkeys was investigated. Birds experimentally inoculated with attenuated and/or virulent H. Read More

View Article and Full-Text PDF

Appendiceal perforation due to biliary stent migration in a neutropenic patient with lung cancer receiving chemotherapy: A case report.

Mol Clin Oncol 2021 Jul 17;15(1):136. Epub 2021 May 17.

Department of Gastrointestinal Surgery, Kanta-Häme Central Hospital, Hämeenlinna 13530, Finland.

The use of biliary stents has become a common and usually safe procedure. However, the migration of biliary stents is an uncommon but well-recognized event after endoscopic retrograde cholangiopancreatography. The migration of plastic stents usually does not result in complications and are spontaneously eliminated from the gastro-intestinal tract. Read More

View Article and Full-Text PDF

Neutropenic enterocolitis-induced sepsis and disseminated intravascular coagulation after chemotherapy: a case report.

BMC Womens Health 2021 05 3;21(1):187. Epub 2021 May 3.

Department of Obstetrics and Gynecology, Shimane University Faculty of Medicine, Enyacho 89-1, Izumo, Shimane, 6938501, Japan.

Background: Neutropenic enterocolitis (NE) is a potentially life-threatening disease that primarily occurs in cancer patients treated with chemotherapy. NE has substantial morbidity and mortality, and its incidence has increased with the widespread use of chemotherapeutic agents such as taxanes, gemcitabine, and leucovorin in patients with lung, breast, gastric, and ovarian cancers. Sometimes NE can be a possible cause of death. Read More

View Article and Full-Text PDF

[58-year-old patient with an unclear abdominal pain].

Dtsch Med Wochenschr 2021 04 14;146(8):511-512. Epub 2021 Apr 14.

Radiologie 360°, Leitung Praxis des MVZ Med 360° Eschweiler, Eschweiler, Deutschland.

View Article and Full-Text PDF

Russell Body Typhlitis: A Case Report and Literature Review.

Int J Surg Pathol 2021 Dec 8;29(8):877-881. Epub 2021 Apr 8.

3710McMaster University, Hamilton, Canada.

Russell bodies are accumulation of immunoglobulin in plasma cells forming intracytoplasmic inclusions. Russell body colitis is rare with only 3 cases described in the English literature up to date. We report a 78-year-old male with cirrhosis showing prominent cecal infiltration of Russell body containing plasma cells. Read More

View Article and Full-Text PDF
December 2021

Good functional outcome following severe neutropenic enterocolitis and perforation in a 48-year-old woman undergoing chemotherapy for breast cancer.

BMJ Case Rep 2021 Mar 2;14(3). Epub 2021 Mar 2.

Anaesthesia, Yeovil District Hospital, Yeovil, UK.

Neutropenic enterocolitis (NEC) is a life-threatening bowel condition, usually resulting from chemotherapy, with a mortality rate thought to be as high as 50%. Markers of poor prognosis include gastrointestinal perforation and bowel wall thickness radiologically detected to be greater than 10 mm. NEC is associated with severe neutropenia and predominantly affects the large bowel; however, we present a case of severe NEC with oesophageal perforation requiring transfer to a specialist upper gastrointestinal unit for corrective stenting. Read More

View Article and Full-Text PDF

Neutropenic Enterocolitis Complicating Induction Chemotherapy in an Acute Myeloid Leukemia Patient.

Cureus 2021 Jan 31;13(1):e13029. Epub 2021 Jan 31.

Internal Medicine, Baystate Medical Center, Springfield, USA.

Neutropenic enterocolitis is a rare inflammatory condition of the ileocecum. Clinicians should be aware of neutropenic enterocolitis in neutropenic patients with hematologic malignancies undergoing chemotherapy as it portends a poor prognosis if not diagnosed early in its course. We report a patient diagnosed with neutropenic enterocolitis within one week of receiving induction chemotherapy for acute myeloid leukemia. Read More

View Article and Full-Text PDF
January 2021

COVID-19-associated pancytopenia and typhlitis.

Am J Emerg Med 2021 07 4;45:685.e1-685.e3. Epub 2021 Jan 4.

Department of Infectious Disease, School of Medicine, Pamukkale University, 20100 Denizli, Turkey.

Neutropenic enterocolitis is also known as typhlitis, is characterized by severe inflammation in the bowel loops. It is often seen in immunosuppressed patients, and it has high morbidity and mortality. Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system and causes COVID-19 (Coronavirus Disease 2019), it may affect hematopoietic and gastrointestinal systems. Read More

View Article and Full-Text PDF

Paclitaxel-Induced Bowel Perforation: A Rare Cause of Acute Abdomen.

Case Rep Gastroenterol 2020 Sep-Dec;14(3):687-694. Epub 2020 Dec 14.

Division of Gastroenterology, BronxCare Hospital Center, a Clinical Affiliate of Mount Sinai Health Systems and Academic Affiliate of Icahn School of Medicine, Bronx, New York, New York, USA.

Paclitaxel, a chemotherapeutic agent, is routinely administered for the treatment of various solid organ malignancies. In rare instances, patients receiving infusions of paclitaxel may present with signs of an acute abdomen. Ischemia and necrosis of the bowel wall from chemotherapy-induced neutropenia and direct toxic effects of the drug have been implicated as the cause. Read More

View Article and Full-Text PDF
December 2020

Candida parapsilosis neutropenic enterocolitis.

Int J Infect Dis 2021 03 9;104:269-270. Epub 2021 Jan 9.

Division of Hematology, Shonan Kamakura General Hospital, Japan.

View Article and Full-Text PDF

Neutropenic Enterocolitis Disclosing an Underlying Cyclic Neutropenia.

Case Rep Pediatr 2020 1;2020:8858764. Epub 2020 Dec 1.

Hematology Department, University Hospital Mohamed VI, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco.

Neutropenic enterocolitis is a syndrome characterized by fever and abdominal pain in a neutropenic patient. It is often reported in children treated for leukemia and rarely reported in patients with other diseases. Herein, we report the case of a 9-year-old patient with a medical history of recurrent fever and mouth ulcers since the age of 4, who presented with neutropenic enterocolitis complicated with intestinal perforation which all leaded to disclose cyclic neutropenia. Read More

View Article and Full-Text PDF
December 2020