Neutropenic enterocolitis: Difference between revisions

Latest revision as of 01:20, 4 October 2022

Fever, abdominal pain, diarrhea, and right lower quadrant tenderness with or without peritonitis in the context of febrile neutropenia
May mimic appendicitis
Mortality of up to 20%

Bowel rest with TPN
Broad-spectrum antibiotics
Consider empiric ganciclovir and oral vancomycin with IV metronidazole, wile awaiting CMV and Clostridioides difficile results

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+== Background ==
 * Inflammation of right-sided colon in the context of febrile neutropenia
-== Background ==
 === Microbiology ===
 * Includes gut [[anaerobes]]
-== Clinical Presentation ==
+== Clinical Manifestations ==
-* Fever, abdominal pain, and right lower quadrant tenderness with or without peritonitis in the context of [[febrile neutropenia]]
+* Fever, abdominal pain, diarrhea, and right lower quadrant tenderness with or without peritonitis in the context of [[febrile neutropenia]]
 * May mimic [[appendicitis]]
+* Mortality of up to 20%
+== Differential Diagnosis ==
+* [[Clostridioides difficile]] diarrhea
+* Colonic ischemia
+* [[CMV]] colitis
+* [[Mycophenolate]]-induced colitis
+== Investigations ==
+* CT shows bowel wall thickening >4 mm
+* Colonoscopy is relatively contraindicated
+== Management ==
+* Bowel rest with [[TPN]]
+* Broad-spectrum antibiotics
+* Consider empiric [[ganciclovir]] and oral [[vancomycin]] with IV [[metronidazole]], wile awaiting [[CMV]] and [[Clostridioides difficile]] results
 [[Category:Immunocompromised hosts‏‎]]