Neutropenic Enterocolitis in a Woman

Patients who become neutropenic after getting combined chemotherapy are at special risk of developing neutropenic enterocolitis (also called typhlitis), a necrotizing inflammation of the cecum..1-10 In 1970, Wagner et al11 first described neutropenic enterocolitis in children with hematologic malignancies or aplastic anemia, but since then many adult cases have been reported.1,3-4,7-10,12 The condition has been detected in 10-46% of patients with acute leukemia,13-14 and in other diseases like acquired immunodeficiency syndrome (AIDS) that lead to profound neutropenia.10,15-16,17 In fact, it is a potential complication of any hematologic or solid malignancy treated with aggressive chemotherapy,6,10,12,15-16,25 especially combined therapy (taxol and doxorubicin,6 cytosinearabinoside and hydoxydaunorubicin,7 etoposide and amsacrine,8 etoposide and high-dose cystosine-arabinoside9). Diarrhea is a side effect of 5-fluorouracil therapy because, particularly when combined with leucovorin, it can damage gut mucosa.15 However, two cases of neutropenic enterocolitis have been associated with 5-fluorouracil treatment; one in a patient with laryngeal carcinoma who received 5-fluorouracil and cisplatin, and the other in a patient with colorectal carcinoma who received 5-fluorouracil and leucovorin.15,25 We describe here another typical case, with a good outcome.