Typhlitis (Neutropenic Enterocolitis)

Portrait of a confident woman with cancer

Overview

Typhlitis describes inflammation of an element of the colon referred to as cecum. It’s a serious condition that always affects individuals with a weakened defense mechanisms. They’re not able to protect against infections like individuals with healthy natural defenses. Typhlitis can also be known as neutropenic enterocolitis, necrotizing colitis, ileocecal syndrome, or cecitis.

Typhlitis mostly affects individuals receiving very intensive chemotherapy drugs to deal with cancer. As the exact reason for typhlitis isn’t completely understood, the problem generally takes place when the intestine is broken, usually as an unwanted effect from the chemotherapy treatment. The intestinal damage combined with the person’s weakened defense mechanisms means they are more susceptible to serious infections. These infections could be fatal.

Signs and symptoms

The twelve signs and signs and symptoms of typhlitis act like individuals of the severe intestinal infection. They frequently seriously all of a sudden and can include:

  • nausea
  • vomiting
  • chills
  • high fever
  • diarrhea
  • stomach discomfort or tenderness
  • bloating

People undergoing chemotherapy might also have neutropenia. Neutropenia is an unwanted effect of chemotherapy. It takes place when the defense mechanisms has abnormally lower levels of neutrophils, a kind of white-colored bloodstream cell essential for battling infections. Signs and symptoms will frequently appear about 2 weeksTrusted Source carrying out a span of chemotherapy.

Causes

Researchers think that typhlitis takes place when the lining from the intestine (mucosa) becomes broken. This damage is usually the result of a chemotherapy drug. It’s believed that many instances of typhlitis in grown-ups result from the growing utilization of a particular kind of cancer treatment referred to as cytotoxic chemotherapy.

The broken intestine will be invaded with opportunistic bacteria or fungi. Normally, an individual’s defense mechanisms would respond to this invasion and get rid of the microorganism. However, those who are immunocompromised won’t have the ability to protect against the problem.

Typhlitis is most generally reported in individuals with the next conditions:

  • eukemia (most typical), a cancer from the bloodstream cells
  • lymphoma, several cancers that begins in cells from the defense mechanisms
  • multiple myeloma, a kind of cancer that affects plasma cells based in the bone marrow
  • aplastic anemia, a kind of anemia in which the bone marrow stops making bloodstream cells
  • myelodysplastic syndromes, several disorders that triggers lower levels of red bloodstream cells, white-colored bloodstream cells, and platelets
  • Aids or AIDS, the herpes virus that destroys cells from the defense mechanisms referred to as T cells
  • It is also reported in people who’ve received a good organ or bone marrow transplant.

Treatment

Typhlitis is really a medical emergency and needs treatment immediately. Doctors haven’t yet determined the easiest method to manage typhlitis.

Presently, treatment involves prompt administration of IV antibiotics, general supportive care (for example intravenous fluids and discomfort relief), and bowel rest. Bowel rest happens when you’re not permitted to drink or eat anything. Rather, you obtain fluids and nutrients via a tube linked to a vein. A suction tube can also be placed with the nose in to the stomach to keep the stomach emptied of digestive juices.

Emergency surgery may be required to deal with complications, for example hemorrhage and bowel perforation. However, surgery in individuals with neutropenia can be quite dangerous and could be delayed, if at all possible, before the neutropenia has improved.

When the typhlitis was the result of a specific kind of chemotherapy, later courses of chemotherapy may need a big change to a new agent.

Complications

The soreness can spread with other areas of the intestine. When the bloodstream supply is stop towards the intestine due to the swelling and injuries, the tissues may die (necrosis). Other complications range from the following:

  • bowel perforation: whenever a hole forms completely with the intestine
  • peritonitis: inflammation from the tissue that lines the abdominal cavity
  • intestinal bleeding (hemorrhage): bleeding in to the intestine
  • intestinal obstruction: once the intestine becomes partly or fully blocked
  • intra-abdominal abscess: a pocket of inflamed tissue full of pus brought on by infection that go into the abdomen
  • sepsis: a existence-threatening infection from the blood stream
  • dying

Outlook

The prognosis for typhlitis is usually inadequate. One research paper discovered that the mortality rate may be as high as 50 % in individuals with typhlitis. Individuals who is able to recover faster from the low white-colored bloodstream cell count generally have better outcomesTrusted Source. Though not common, typhlitis can recur despite treatment.

Early diagnosis and aggressive strategy to typhlitis is required for any good outcome, but advances in medical technology are anticipated to enhance outcomes later on.

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