Imaging and Clinical Features of Typhlitis in Pediatric Cancer Patients on Chemotherapy at Tikur Anbessa Specialized Hospital
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Date
2020-12
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Addis Abeba University
Abstract
Background: Typhlitis also known as neutropenic enterocolitis is a necrotizing enteropathy ofthe right colon. It is characterized by the clinical triad of fever, abdominal pain, neutropenia andimaging findings of right-side colonic inflammation. It is most often seen in the setting of severeneutropenia in immunesuppressed patients who are undergoing treatment for malignancies, inthose who have undergone organ transplant(s) or have congenital or acquired causes of immunesuppresion. We report the clinical and imaging findings of typhlitis in pediatric cancerpatients who have taken chemotherapy in the largest tertiary center in Addis Ababa, Ethiopiaover a period of 20 months.
Methods: Medical records of hospitalized patients were screened for plain radiograph,ultrasound and computerized tomographic scan requests for suspected typhlitis in those oninpatient cancer treatment (November 2018- July 2020 G.C). Retrospective case note analysiswas done to collect the clinical data of those with typhlitis.
Result: Typhlitis was identified in 4.2% (12/286) of the patients on chemotherapy. Elevenpatients (91.7%) had hematologic malignancies (leukemia, lymphoma), 1 patient had a solidtumor (Head and neck embryonal RMS). Most (83.3%) had abdominal pain, diarrhea andneutropenia. Fever was identified in 67.7% of patients. All had ultrasound evidence supportive of typhlitis. All were treated with IV antibiotics. There were no complications requiring surgicalintervention. No child died during an episode of typhlitis.
Conclusion: The magnitude of typhlitis was found to be comparable to what is reported in otherstudies. The clinical findings of abdominal pain, diarrhea, fever in a neutropenic patient who hassigns of colonic inflammation should prompt for the diagnosis of this case.
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Typhlitis ,pediatric cancer, chemotherapy