Neutropenic Enterocolitis

Excerpt

Neutropenic enterocolitis (NE) has been a life-threatening condition with a mortality rate of 30% to 50%. It is also known as typhlitis, from the Greek typhi or “blind” in reference to the blind-ending cecum, which describes neutropenic enterocolitis of the cecum that affects the ileal region as well and can spread to the ascending colon. Neutropenic enterocolitis is characterized by bowel wall edema, ulceration, and hemorrhage, and it mainly occurs in immunosuppressed patients. Although poorly understood, NE appears to be the result of intestinal mucosal injury in the setting of neutropenia that can be due to treatment with cytotoxic chemotherapy, radiation, or leukemic infiltration. NE is recognized as a substantial cause of morbidity and mortality in immunosuppressed patients. Therefore, a high index of suspicion and early diagnosis is eminent. In this article, we assess recent concepts about the pathogenesis, diagnosis, and management of neutropenic enterocolitis.