Neutropenic enterocolitis (typhlitis)
- Louis-Michel Wong Kee Song, MD, FRCP(C)
Louis-Michel Wong Kee Song, MD, FRCP(C)
- Associate Professor of Medicine
- Mayo Medical School
- Norman E Marcon, MD, FRCP(C)
Norman E Marcon, MD, FRCP(C)
- Professor of Medicine
- University of Toronto
Neutropenic enterocolitis is a life-threatening, necrotizing enterocolitis occurring primarily in neutropenic patients . Other terms that have been used to describe this syndrome include "necrotizing enterocolitis" and "ileocecal syndrome." Neutropenic enterocolitis occurs most commonly in individuals with hematologic malignancies who are neutropenic and have breakdown of gut mucosal integrity as a result of cytotoxic chemotherapy. "Typhlitis" (from the Greek word "typhlon," or cecum) describes neutropenic enterocolitis of the ileocecal region; we prefer the more inclusive term "neutropenic enterocolitis," since other parts of the small and/or large intestine are often involved.
The pathogenesis, clinical manifestations, diagnosis, management, and prognosis of neutropenic enterocolitis are reviewed here.
Other infectious complications of chemotherapy-induced neutropenia are discussed separately:
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- RISK FACTORS AND INCIDENCE
- CLINICAL MANIFESTATIONS
- Signs and symptoms
- DIFFERENTIAL DIAGNOSIS
- Antimicrobial therapy
- - Suggested regimens
- - Duration and transition to an oral regimen
- Supportive therapy
- - Granulocyte colony-stimulating factor
- Subsequent chemotherapy
- SUMMARY AND RECOMMENDATIONS