title: Citrobacter freundii and fatal neutropenic enterocolitis following adjuvant chemotherapy for breast cancer.
abstract: Neutropenic enterocolitis is increasingly being recognized as a life-threatening complication of chemotherapy, mainly for haematological and lymphoproliferative malignancies. It is under-recognized clinically, with the diagnosis often being made on post-mortem examination. Although active medical management is generally preferred, surgical intervention may be indicated. We report a case of fatal neutropenic enterocolitis, secondary to Citrobacter freundii, following adjuvant chemotherapy for breast cancer. We also review the literature, examining the aetiology, diagnosis and management of this often fatal entity.
authors.affiliation: Christie Hospital, Manchester, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Clemons
authors.forename: J W
authors.initials: JW
authors.lastname: Valle
authors.forename: M
authors.initials: M
authors.lastname: Harris
authors.forename: S
authors.initials: S
authors.lastname: Ellenbogen
authors.forename: A
authors.initials: A
authors.lastname: Howell
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D016971:Citrobacter freundii; D004756:Enterobacteriaceae Infections / Q000209:etiology*; D004760:Enterocolitis / Q000209:etiology / Q000382:microbiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*