-
Canadian Journal of Surgery. Journal... Dec 1999To provide an overview of the pathophysiological features and management of the clinical entity typhlitis. (Review)
Review
OBJECTIVE
To provide an overview of the pathophysiological features and management of the clinical entity typhlitis.
DATA SOURCES AND STUDY SELECTION
The data presented are derived from a review of the English-language literature on typhlitis. The majority of papers analysed were small clinical series.
DATA EXTRACTION AND SYNTHESIS
Data derived from the literature review were collated. The major finding was that typhlitis comprises a number of different diseases characterized by the presence of right lower quadrant pain, an immunocompromised host and altered function of the mucosal barrier of the right colon.
CONCLUSIONS
Typhlitis should be suspected in any immunocompromised patient presenting with right lower quadrant pain with compatible radiographic findings. Most patients can be treated conservatively with intravenously administered fluids and antibiotics, although surgery may be necessary if complications arise.
Topics: Enterocolitis; Humans; Intestinal Mucosa; Opportunistic Infections; Prognosis
PubMed: 10593241
DOI: No ID Found -
Journal of Ultrasound Mar 2019Typhlitis, also known as neutropenic colitis, is a rare inflammatory condition and a potentially life-threatening disease process that typically involves the cecum.... (Review)
Review
PURPOSE
Typhlitis, also known as neutropenic colitis, is a rare inflammatory condition and a potentially life-threatening disease process that typically involves the cecum. Delay in diagnosis may lead to a fatal prognosis with a death rate of 21-48%. Ultrasound evaluation of right lower quadrant may lead to an accurate and rapid diagnosis.
METHODS
We describe the case of a 59-year-old female with advanced Churg-Strauss syndrome treated with cyclophosphamide, with acute right lower quadrant pain.
RESULTS
Ultrasound was the first diagnostic step in the diagnosis of typhlitis. Sonographic findings were comparable to CT imaging.
CONCLUSIONS
Bowel bedside ultrasound evaluation in emergency settings may lead to a prompt and definitive diagnosis. Although CT is considered the gold standard in the diagnosis and staging of neutropenic colitis, ultrasound was able to identify the pathology accurately. Ultrasound findings of typhlitis are highly characteristic, showing circumferential wall thickening with predominant submucosa.
Topics: Abdominal Pain; Cecum; Churg-Strauss Syndrome; Cyclophosphamide; Early Diagnosis; Emergency Medical Services; Female; Humans; Immunosuppressive Agents; Middle Aged; Point-of-Care Testing; Typhlitis; Ultrasonography
PubMed: 30367357
DOI: 10.1007/s40477-018-0333-2 -
Expert Review of Hematology Feb 2017Typhlitis is an abdominal complication of cancer chemotherapy, affecting mostly patients receiving intensive chemotherapeutic regimens with high potential to induce... (Review)
Review
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.
Topics: Acute Disease; Adult; Combined Modality Therapy; Disease Management; Humans; Incidence; Leukemia; Multimodal Imaging; Phenotype; Prognosis; Risk Factors; Treatment Outcome; Typhlitis; Young Adult
PubMed: 28075196
DOI: 10.1080/17474086.2017.1280389 -
The Chicago Medical Journal 1867
PubMed: 37412993
DOI: No ID Found -
The Hospital Apr 1890
PubMed: 29826825
DOI: No ID Found -
International Journal of Surgical... Dec 2021Russell bodies are accumulation of immunoglobulin in plasma cells forming intracytoplasmic inclusions. Russell body colitis is rare with only 3 cases described in the... (Review)
Review
Russell bodies are accumulation of immunoglobulin in plasma cells forming intracytoplasmic inclusions. Russell body colitis is rare with only 3 cases described in the English literature up to date. We report a 78-year-old male with cirrhosis showing prominent cecal infiltration of Russell body containing plasma cells. Plasma cells showed no nuclear atypia or mitoses, and no evidence of light chain restriction. In this article, we report a fourth case of Russell body colitis, that is unique in being localized to the cecum in contrast to the other 3, 1 of which was in an inflammatory polyp in the sigmoid colon, 1 in a rectal tubulovillous adenoma and 1 as part of diffuse gastrointestinal disease. This is therefore the first report of localized Russell body typhlitis, occurring in a cirrhotic patient in whom an adjacent erosion was likely nonsteroidal anti-inflammatory drug-associated, a combination that may have facilitated the formation of Russell bodies.
Topics: Aged; Cecum; Cytoplasm; Humans; Inclusion Bodies; Intestinal Mucosa; Male; Plasma Cells; Typhlitis
PubMed: 33829929
DOI: 10.1177/10668969211008251 -
World Journal of Gastroenterology Jan 2017Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease... (Review)
Review
Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury (mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. This article aims to review current concepts regarding neutropenic colitis' pathogenesis, diagnosis, and management.
Topics: Anti-Bacterial Agents; Antineoplastic Agents; Colectomy; Combined Modality Therapy; Enterocolitis, Neutropenic; Fluid Therapy; Humans; Leukocyte Transfusion; Lower Body Negative Pressure; Neoplasms; Neutropenia; Parenteral Nutrition; Typhlitis
PubMed: 28104979
DOI: 10.3748/wjg.v23.i1.42 -
Emergency Medicine Clinics of North... Aug 2021Pediatric hematologic and oncologic emergencies are in 3 major categories: complications of hematologic disorders, emergencies associated with the new onset of cancers,... (Review)
Review
Pediatric hematologic and oncologic emergencies are in 3 major categories: complications of hematologic disorders, emergencies associated with the new onset of cancers, and treatment-associated oncologic emergencies. The overall number of these patients remains low; however, the mortality associated with these diseases remains high despite significant advances in management. This article presents a review of the most commonly encountered pediatric hematologic and oncologic complications that emergency physicians and providers need to know.
Topics: Anemia, Sickle Cell; Antineoplastic Agents; Child; Drug-Related Side Effects and Adverse Reactions; Humans; Incidence; Neoplasms; Pediatric Emergency Medicine; Prevalence; Purpura, Thrombocytopenic, Idiopathic
PubMed: 34215402
DOI: 10.1016/j.emc.2021.04.007 -
The American Journal of Emergency... Jul 2021Neutropenic enterocolitis is also known as typhlitis, is characterized by severe inflammation in the bowel loops. It is often seen in immunosuppressed patients, and it...
Neutropenic enterocolitis is also known as typhlitis, is characterized by severe inflammation in the bowel loops. It is often seen in immunosuppressed patients, and it has high morbidity and mortality. Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system and causes COVID-19 (Coronavirus Disease 2019), it may affect hematopoietic and gastrointestinal systems. Herein, we present a rare case of COVID-19-associated pancytopenia and typhlitis in a 60-year-old female who presented with abdominal pain. Contrast-enhanced abdominal computed tomography (CT) demonstrated the bowel wall thickening in the cecum and ascending colon compatible with enterocolitis. Moreover, the chest CT showed bilateral, peripheral, and multifocal ground-glass opacities, consistent with COVID-19 pneumonia. We also aimed to emphasize the laboratory, clinical, and CT findings of the patient.
Topics: COVID-19; Colon; Female; Humans; Lung; Middle Aged; Pancytopenia; Pandemics; SARS-CoV-2; Tomography, X-Ray Computed; Typhlitis
PubMed: 33446380
DOI: 10.1016/j.ajem.2020.12.049