|Classification and external resources|
|ICD-9-CM||540.0 540.9 541|
Neutropenic enterocolitis, also known as typhlitis or typhlenteritis, and less commonly called caecitis or cecitis, is inflammation of the cecum (part of the large intestine) that may be associated with infection. It is particularly associated with neutropenia, a low level of neutrophil granulocytes (the most common form of white blood cells) in the blood.
Signs and symptoms
The condition is usually caused by Gram-positive enteric commensal bacteria of the gut (gut flora). Clostridium difficile is a species of Gram-positive bacteria that commonly causes severe diarrhea and other intestinal diseases when competing bacteria are wiped out by antibiotics, causing pseudomembranous colitis, whereas C. septicum is responsible for most cases of neutropenic enterocolitis.
Successful treatment hinges on:
- Early diagnosis provided by a high index of suspicion and the use of CT scanning
- Nonoperative treatment for uncomplicated cases
- Elective right hemicolectomy to prevent recurrence
"...The authors have found nonoperative treatment highly effective in patients who do not manifest signs of peritonitis, perforation, gastrointestinal hemorrhage, or clinical deterioration. Recurrent typhlitis was frequent after conservative therapy (recurrence rate, 67 percent), however."
Inflammation can spread to other parts of the gut in patients with typhlitis. The condition can also cause the cecum to become distended and can cut off its blood supply. This and other factors can result in necrosis and perforation of the bowel, which can cause peritonitis and sepsis.
The mortality rate for typhlitis can be as high as 50%, mostly because it is frequently associated with bowel perforation.
- Definition at thefreedictionary.com
- Stoer TM, Koslin DB (2004). "Typhlitis Imaging". Medscape. WebMD LLC. Retrieved September 3, 2016.
- Keidan RD, Fanning J, Gatenby RA, Weese JL (Mar 1989). "Recurrent typhlitis. A disease resulting from aggressive chemotherapy". Dis Colon Rectum. 32(3): 206–9. doi:10.1007/BF02554529. PMID 2920627.
- Boggio L, Pooley R, Winter JN (February 2000). "Typhlitis complicating autologous blood stem cell transplantation for breast cancer". Nature. Macmillan Publishers Limited. 25 (3): 321–6.