J Korean Cancer Assoc.  1997 Oct;29(5):906-913.

Four Cases of Typhlitis, Developed in Neutropenic State and Treated with Medical Conservative Management

• Kim PW
• Ji HG
• Jeong HS
• Moon CI
• Yang DK
• Lee SW
• Jung YS
• Choi JH
• Nam GH
• Lee JH
• Shin DB

Abstract

Typhlitis is a life threatening necrotizing enterocolitis of the cecum, ascending colon and terminal ileum seen in severely neutropenic patients, however its pathogenesis is not identified up to this time.The incidence of typhlitis in leukemic patient is 10~12%, estimated by postmortem examination, and 46% in induction chemotherapy of leukemia. Recently, entity incidence is more high due to increasing challenges to high dose chemotherapy in solid tumors.We experienced four cases of typhlitis, one was developed in the circumstance of neutropenia induced by induction chemotherapy for acute myelocytic leukemia and others in neutropnia due to primary diseases without chemotherapy, ig, chronic myelocytic leukemia, acute lymphocytic leukemia, myelodysplastic syndrome.All cases were treated with high dose broad spectrum antibiotics in early phase of disease and its outcome was good, so that, early diagnosis of typhlitis is essential, then prompt treatment with high dose antibiotics and intravenous fluid before onset of transmural necrosis is associated with lower morbidity and mortality than surgical resection.

Keyword

Typhlitis; Neutropenia; Antibiotics; Chemotherapy

MeSH Terms

Anti-Bacterial Agents
Autopsy
Cecum
Colon, Ascending
Drug Therapy
Early Diagnosis
Enterocolitis, Necrotizing
Humans
Ileum
Incidence
Induction Chemotherapy
Leukemia
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukemia, Myeloid, Acute
Mortality
Necrosis
Neutropenia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Typhlitis*
Anti-Bacterial Agents