Typhlitis in acute childhood leukemia.
OBJECTIVE
To review our experience with typhlitis among children treated for acute leukemia.


METHODS
The medical records of children with acute leukemia and typhlitis between 2006 and 2009 were reviewed for demographics and symptoms, and for microbiological and imaging findings.


RESULTS
In the 75 children with acute leukemia--54 with acute lymphoblastic leukemia (ALL) and 21 with acute myeloid leukemia (AML)--there were 10 episodes of typhlitis (4.5%) that developed during 221 periods of severe neutropenia. The cumulative risk of typhlitis was 7.4% in patients with ALL and 28.5% in patients with AML. Frequent symptoms were: abdominal pain and tenderness (100% each); fever and nausea (90% each); emesis (80%); diarrhea (50%), and hypotension, peritonitis and abdominal distension (10% each). The median duration of symptoms was 6 days (range: 2-11 days), and that of neutropenia 14 days (range: 3-25 days). All patients were treated medically and none surgically. Two patients died because of typhlitis and sepsis.


CONCLUSIONS
In our study, the rate of typhlitis among leukemic children was 4.5%; however, the mortality rate was 20%. Thus, rapid identification and timely, aggressive medical intervention are necessary to reduce the morbidity and mortality from typhlitis.
Department of Pediatric Hematology, Dr. Sami Ulus Children's Hospital, Ankara, Turkey.
Esma
E
Altınel
Nese
N
Yarali
Pamir
P
Isık
Ali
A
Bay
Abdurrahman
A
Kara
Bahattin
B
Tunc
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D053706:Typhlitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000900:Anti-Bacterial Agents