Conservative management of acute appendicitis in children with hematologic malignancies during chemotherapy-induced neutropenia.
The management of acute appendicitis in the febrile neutropenic patient after intensive chemotherapy is controversial. We report our single-center-experience of 5 children diagnosed with appendicitis during febrile neutropenia after chemotherapy for acute leukemia or lymphoma. All patients presented with an isolated appendicitis without signs of overt mucositis or more diffuse enterocolitis. The clinical diagnosis was confirmed by ultrasonography. Perforation with retrocecal abscess was present in 1 patient. Administration of combination antimicrobial regimens including meropenem resulted in complete resolution in all patients. Our observations indicate that acute appendicitis in clinically stable neutropenic cancer patients can be managed conservatively without surgery.
Department of Pediatric Oncology, University Children's Hospital, University of Zurich, Zurich, Switzerland.
Verena A
VA
Wiegering
Christian J
CJ
Kellenberger
Nicole
N
Bodmer
Eva
E
Bergstraesser
Felix
F
Niggli
Michael
M
Grotzer
David
D
Nadal
Jean-Pierre
JP
Bourquin
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001064:Appendicitis / Q000150:complications* / Q000188:drug therapy*; D002648:Child; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D000077731:Meropenem; D009503:Neutropenia / Q000139:chemically induced*; D013845:Thienamycins / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem