title: Typhlitis (neutropenic enterocolitis) in patients with acute leukemia: a review.
abstract: Typhlitis is an abdominal complication of cancer chemotherapy, affecting mostly patients receiving intensive chemotherapeutic regimens with high potential to induce mucosal damage, such as patients with acute leukemia. Despite being relatively frequent, there are no randomized trials or high-quality cohort studies addressing important aspects of the diagnosis and management of the disease. Areas covered: In this review we discuss the gaps in the literature, acknowledging that the evidences for recommendations regarding the management of typhlitis are mostly expert opinion. We performed a computerized search of the MEDLINE database (PubMed version) for appropriate articles published from 1963 through July, 2016 in English language. Thereafter the reference lists of all identified studies were screened, reviewing the abstracts of all potentially pertinent articles for inclusion. Expert commentary: The diagnosis of typhlitis still relies on clinical and radiologic features consisting of fever, abdominal pain and thickness of a segment of the bowel wall, as seen by ultrasonography or CT scan. The treatment consists in antimicrobial therapy with a regimen that covers the most frequent pathogens, taking into consideration the local epidemiology. Other measures include bowel rest, and the use of G-CSF. Surgery is indicated only in selected situations.
authors.affiliation: a Department of Internal Medicine , University Hospital, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Portugal
authors.affiliation: a Department of Internal Medicine , University Hospital, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil.
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
mesh_terms: D000208:Acute Disease; D000328:Adult; D003131:Combined Modality Therapy; D019468:Disease Management; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000150:complications*; D064847:Multimodal Imaging; D010641:Phenotype; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome; D053706:Typhlitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
keywords: Typhlitis; enterocolitis; epidemiology; febrile neutropenia; treatment