Painless neutropenic enterocolitis in a patient undergoing chemotherapy.
METHODS
A 60-year-old man developed painless neutropenic enterocolitis after induction chemotherapy for newly diagnosed acute myelogenous leukemia. The patient had recurrent fever while neutropenic, without experiencing abdominal pain or tenderness on physical examination. His diagnosis was delayed by the fact that he had no localizing symptoms.


CONCLUSIONS
Neutropenic enterocolitis is a common complication, generally occurring in patients who are severely neutropenic; the condition presents with fever and abdominal pain. No cases of painless neutropenic enterocolitis have yet been reported. Review of the literature shows that patients can develop this condition in the absence of fever and, sometimes, neutropenia. Furthermore, few comprehensive studies or reviews have investigated the utility of computed tomography imaging in identifying a source for abdominal pain in neutropenic patients with fever.


CONCLUSIONS
Many potential causes of febrile neutropenia should be considered in chemotherapy patients.
Departments of Medicine and Pediatrics, Warren Alpert Medical School of Brown University, Rhode Island Hospital, and Hasbro Children's Hospital, Providence, RI, U.S.A.
E J
EJ
Chow
Department of Medicine, Division of Hematology and Oncology, Warren Alpert Medical School of Brown University, Providence, RI, U.S.A.
K D
KD
Bishop
Enterocolitis; fever; neutropenia; painless enterocolitis