[Clinical and microbiological characteristics of neutropenic enterocolitis in adults with blood cancer in the National Cancer Institute of Bogota D.C. (Colombia)].
OBJECTIVE
This study describes the clinical, epidemiological and microbiological characteristics of adult patients with blood cancer and neutropenic enterocolitis treated in the Instituto Nacional de Cancerologia (National Cancer Institute) in Bogota, Colombia.


METHODS
The clinical histories of 692 adult patients hospitalized in the Instituto Nacional de Cancerologia between 1997 and 2001 with a diagnosis of leukemia or lymphoma were reviewed. Thirty-five of these cases met the criteria for probable or confirmed neutropenic enterocolitis.


RESULTS
Twenty-two cases were confirmed and the remaining 13 were probable neutropenic enterocolitis. All patients were undergoing chemotherapy and all presented watery diarrhea and abdominal pain. In addition, 17% had melena and 25% severe vomiting. Eight of 26 stool cultures (30%) and 17 of 32 (58%) blood cultures were positive for potentially pathogenic microorganisms, particularly gram-negative bacilli. Three patients with probable neutropenic enterocolitis and ten confirmed cases died (37%); mortality was higher among patients who were managed surgically.


CONCLUSIONS
Neutropenic colitis presents as a multifactorial syndrome in patients with blood cancer undergoing cytotoxic therapy with agents such as cytosine arabinoside, etoposide, vincristine, cyclophosphamide and corticoids. This highly lethal complication is partly due to infections caused by gram-negative bacilli.
Servicio de Medicina Interna, Instituto Nacional de Cancerología, Pontificia Universidad Javeriana, Bogotá, Colombia.
Andrés Felipe
AF
Cardona
Juan Felipe
JF
Combariza
Ludovic
L
Reveiz
Edgar Guillermo
EG
Ospina
Claudia Marcela
CM
Poveda
Carlos Adrián
CA
Ruiz
Pedro
P
Ramos
Diego Mauricio
DM
Aponte
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003105:Colombia / Q000453:epidemiology; D004198:Disease Susceptibility; D044504:Enterocolitis, Neutropenic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D019337:Hematologic Neoplasms / Q000150:complications*; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D014057:Tomography, X-Ray Computed