Acute typhlitis in inmunocompromised patient: an eight year experience.
BACKGROUND
Acute typhlitis is usually associated with severe immunosuppressive conditions. Initially described as closely associated with infantile myeloid leukaemia, its incidence increased along the last decade.


METHODS
retrospective review.


METHODS
12 immunodepressed patients affected of acute typhilis in our hospital between 1994 and 2001. Suspected diagnosis was established by clinical symptoms and abdominal CT findings, and was confirmed with pathological finding in the surgical specimen. Clinical and radiological diagnosis, treatment, complications and survival of patients are discussed.


RESULTS
3 patients with a previous diagnosis af acute myeloid leukemia, 2 patients with non-Hodgkin lymphoma, 2 patients with aplastic anaemia, one patient with AIDS, and 4 patients with kidney transplantation were included in our study. Prednisone, cyclosporine, Ara-C and vincristine were the most frequently involved drugs. Most frequent clinical findings included abdominal pain, fever, nausea-vomiting and abdominal distension. CT diagnosis revealed caecum and colic involvement with rarefaction of pericaecal fat. Medical treatment was successful in only 33% of all patients, the other patients requiring a surgical procedure including right hemicolectomy with or without intestinal anastomosis. Mortality reached 58.3 per cent, representing multiorganic sepsis the main cause of death.


CONCLUSIONS
although early diagnosis of acute typhlitis bears a better prognosis, mortality rates are up 50 % in spite of an established treatment.
Bueno Lledó
J
J
Service of General Surgery and digestive II, Hospital Universitario La Fe, Valencia, Spain. buenolledo@hotmail.com
Serralta Serra
A
A
Hernanadis Villalva
J
J
Planells Roig
M
M
Rodero Rodero
D
D
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000276:immunology; D000208:Acute Disease; D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000276:immunology; D002429:Cecal Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D003082:Colectomy; D004760:Enterocolitis / Q000175:diagnosis; D005260:Female; D006801:Humans; D007081:Ileostomy; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007249:Inflammation; D016030:Kidney Transplantation; D007951:Leukemia, Myeloid / Q000150:complications / Q000276:immunology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D007166:Immunosuppressive Agents