Korean J Pediatr.  2008 Feb;51(2):156-161. 10.3345/kjp.2008.51.2.156.

Outcome of typhlitis in children with cancer

• Lee JM
• Choi KH
• Hah JO

• KMID: 2280224
• DOI: http://doi.org/10.3345/kjp.2008.51.2.156

Abstract

PURPOSE: Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. The optimal management for typhlitis in pediatric oncology patients has been debateful between operative and nonoperative approaches. The purpose of this study was to review the outcome of medical management of patients who were diagnosed as typhlitis.
METHODS
The records of 207 pediatric cancer patients who were diagnosed and treated at the pediatric department of Yeungnam University Hospital for cancer between August, 2002 and July, 2007 were reviewed.
RESULTS
Among 207 patients, 12 (5.7%) children aged 9 to 14 years, were diagnosed clinically to have typhlitis. Clinical symptoms and signs of patients were fever, abdominal pain and tenderness, diarrhea, vomiting and rebound tenderness. Bowel-wall thickening (> 4mm) was seen on CT or ultrasonography. All patients were treated with antibiotics combinations of teicoplanin, carbapenem, aminoglycoside, or other third generation cephalosporin and metronidazole or clindamycin. Eight patients were treated with additional antifungal agents. Other supportive management included bowel rest, total parenteral nutrition, and G-CSF administration. All patients recovered completely and did not need any surgical management.
CONCLUSION
Early diagnosis and aggressive supportive treatment appears to be important for complete recovery and survival of typhlitis.

Keyword

Typhlitis; Enterocolitis; Neutropenia

MeSH Terms

Abdominal Pain
Aged
Anti-Bacterial Agents
Antifungal Agents
Child
Clindamycin
Diarrhea
Early Diagnosis
Enterocolitis
Enterocolitis, Neutropenic
Fever
Granulocyte Colony-Stimulating Factor
Humans
Inflammation
Metronidazole
Neutropenia
Parenteral Nutrition, Total
Teicoplanin
Typhlitis
Vomiting
Anti-Bacterial Agents
Antifungal Agents
Clindamycin
Granulocyte Colony-Stimulating Factor
Metronidazole
Teicoplanin