Neutropenic enterocolitis (typhlitis) after pediatric bone marrow transplant.
OBJECTIVE
Neutropenic enterocolitis (typhlitis) is a common consideration after bone marrow transplantation. This study reviews the authors' experience with abdominal pain and typhlitis in an active pediatric bone marrow transplant program.


METHODS
The Pediatric Bone Marrow Transplant Program Database was reviewed for patients presenting with abdominal pain or typhlitis.


RESULTS
From 1993 to 2000 a total of 142 transplants have been performed. Of these, 97 patients had abdominal pain, and 5 had radiologically proven typhlitis. Nonspecific abdominal pain developed on the 12 +/- 11th day posttransplant, whereas patients in whom typhlitis developed were diagnosed on day 15.5 +/- 7. All patients were treated with prophylactic antibiotics consisting of acyclovir, fluconazole, and septra. With the onset of abdominal pain, 73 of 97 patients were placed on therapeutic antibiotics; patients identified with typhlitis had amphotericin plus GCSF added. No clinical features differentiated abdominal pain patients from typhlitis. Oral feeding and time of discharge was similar in both groups. Surgical intervention was not required, and no patients died with typhlitis.


CONCLUSIONS
Abdominal pain is a common symptom after bone marrow transplant; however, typhlitis is relatively rare, and surgical intervention was not required in this series. Broad-spectrum (including fungal) antibiotic therapy appears to be an effective treatment for typhlitis in this patient population.
Otaibi
A Al
AA
Calgary, Alberta.
Barker
C
C
Anderson
R
R
Sigalet
D L
DL
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D016360:Clostridioides difficile / Q000302:isolation & purification; D003937:Diagnosis, Differential; D004760:Enterocolitis / Q000175:diagnosis* / Q000209:etiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009503:Neutropenia / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed