Abstract

AIM
To describe the symptoms, clinical management and short-term outcome in a series of paediatric oncology patients with severe typhlitis following conservative treatment.
METHODS
Twelve episodes of severe typhlitis in 11 children with cancer treated at the paediatric oncology ward at Queen Silvias Children's Hospital between 1995 and 2006 were analysed retrospectively. Data on symptoms, radiological findings, laboratory status and treatment as well as outcome were collected and analysed.
RESULTS
In all episodes, the classical signs of neutropenia, fever, abdominal pain and thickening of the bowel wall were present. All were successfully treated with bowel rest, broadspectrum antibiotics and supportive care. After recovery from typhlitis, three patients needed surgical intervention because of complications.
CONCLUSION
A high clinical suspicion combined with radiological imaging aids early diagnosis. Predisposing factors for developing typhlitis were haematologic malignancy and treatment with chemotherapy within 3 weeks of onset. Supportive care, bowel rest including parenteral nutrition, correction of cytopenias and aggressive antimicrobial treatment is essential. Measurements of C-reactive protein in blood may be of benefit when assessing the clinical course.

Links

Publisher Full Text

Authors

Sundell N, Boström H, Edenholm M, Abrahamsson J

Institution

Department of Pediatrics, Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden. nicklas.sundell@vgregion.se

Source

Acta paediatrica (Oslo, Norway : 1992) 101:3 2012 Mar pg 308-12

MeSH

Adolescent
Antineoplastic Agents
Child
Child, Preschool
Enterocolitis, Neutropenic
Female
Humans
Infant
Male
Neoplasms
Retrospective Studies
Treatment Outcome
Typhlitis

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

21910749