Imaging and Clinical Features of Typhlitis in Pediatric Cancer Patients on Chemotherapy at Tikur Anbessa Specialized Hospital

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Addis Abeba University


Background: Typhlitis also known as neutropenic enterocolitis is a necrotizing enteropathy of the right colon. It is characterized by the clinical triad of fever, abdominal pain, neutropenia and imaging findings of right-side colonic inflammation. It is most often seen in the setting of severe neutropenia in immunesuppressed patients who are undergoing treatment for malignancies, in those 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 cancer patients who have taken chemotherapy in the largest tertiary center in Addis Ababa, Ethiopia over 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 on inpatient cancer treatment (November 2018- July 2020 G.C). Retrospective case note analysis was done to collect the clinical data of those with typhlitis. Result: Typhlitis was identified in 4.2% (12/286) of the patients on chemotherapy. Eleven patients (91.7%) had hematologic malignancies (leukemia, lymphoma), 1 patient had a solid tumor (Head and neck embryonal RMS). Most (83.3%) had abdominal pain, diarrhea and neutropenia. 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 surgical intervention. No child died during an episode of typhlitis. Conclusion: The magnitude of typhlitis was found to be comparable to what is reported in other studies. The clinical findings of abdominal pain, diarrhea, fever in a neutropenic patient who has signs of colonic inflammation should prompt for the diagnosis of this case.



Typhlitis ,pediatric cancer, chemotherapy