A neutropenic cancer patient that presents with right lower quadrant abdominal pain, fever, and bloody diarrhea should raise suspicion for typhlitis (necrotizing colitis, cecal inflammation). This most commonly occurs in patients with hematologic malignancies who have been treated with cytotoxic agents. This condition is high risk and is associated with high morbidity and mortaiity.
Treatment:
Broad-spectrum antibiotics
CT scan of the abdomen and pelvis
Surgical consultation
Usually requires ICU admission
References
1. D'Souza S, et al. Typhlitis as a presenting manifestation of acute myelogenous leukemia. South Med J 2000;93:218-220
2. Ellerin TB, Diaz LA. Evidence-Based Medicine-500 Clues To Diagnosis and Treatment. 2001
