Antineoplastics
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Reactions 1465, p8 - 17 Aug 2013 S Antineoplastics Typhlitis: case report A 54-year-old man developed typhlitis (neturopenic enterocolitis) following R-CHOP chemotherapy for non- Hodgkin lymphoma [routes and dosages not stated]. The man was diagnosed with diffuse large B-cell lymphoma and received a first cycle of rituximab, cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [Oncovin] and prednisolone. On week later, he presented with a 1-day history of oral mucositis and acute onset of fever. His WBC count was 0.2 × 10 3 /µL and he had an absolute neutrophil count (ANC) of zero. Due to a diagnosis of febrile neutropenia, he began receiving cefepime. On hospital day 3, he developed vomiting, water diarrhoea, acute abdominal pain, guarding and rebound tenderness. An abdominal CT revealed a distended caecum with circumferential wall thickening and hyperenhancing mucosa. A diagnosis of typhlitis was made. Stool PCR was positive for toxigenic Clostridium difficile, and he was also diagnosed with C. difficile colitis. Vancomycin, metronidazole and micafungin were added to the man’s cefepime regimen. His symptoms resolved over the following 10 days, and his ANC count increased to 1.9 × 10 3 /µL prior to discharge. He subsequently received a second cycle of R-CHOP, without complication. Author comment: "The risk factors for typhlitis include recent chemotherapy within 2 weeks." Junpaparp P, et al. Concomitant typhlitis and Clostridium difficile colitis developed after first R-CHOP chemotherapy in a non-Hodgkin lymphoma patient. BMJ Case Reports : Jan 2013. Available from: URL: http://dx.doi.org/10.1136/ bcr-2013-008894 - USA 803091368 1 Reactions 17 Aug 2013 No. 1465 0114-9954/13/1465-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1465, p8 - 17 Aug 2013
SAntineoplastics
Typhlitis: case reportA 54-year-old man developed typhlitis (neturopenic
enterocolitis) following R-CHOP chemotherapy for non-Hodgkin lymphoma [routes and dosages not stated].
The man was diagnosed with diffuse large B-cell lymphomaand received a first cycle of rituximab, cyclophosphamide,doxorubicin [hydroxydaunorubicin], vincristine [Oncovin] andprednisolone. On week later, he presented with a 1-dayhistory of oral mucositis and acute onset of fever. His WBCcount was 0.2 × 103/µL and he had an absolute neutrophilcount (ANC) of zero. Due to a diagnosis of febrile neutropenia,he began receiving cefepime. On hospital day 3, he developedvomiting, water diarrhoea, acute abdominal pain, guarding andrebound tenderness. An abdominal CT revealed a distendedcaecum with circumferential wall thickening andhyperenhancing mucosa. A diagnosis of typhlitis was made.Stool PCR was positive for toxigenic Clostridium difficile, andhe was also diagnosed with C. difficile colitis.
Vancomycin, metronidazole and micafungin were added tothe man’s cefepime regimen. His symptoms resolved over thefollowing 10 days, and his ANC count increased to 1.9 × 103/µLprior to discharge. He subsequently received a second cycle ofR-CHOP, without complication.
Author comment: "The risk factors for typhlitis includerecent chemotherapy within 2 weeks."Junpaparp P, et al. Concomitant typhlitis and Clostridium difficile colitis developedafter first R-CHOP chemotherapy in a non-Hodgkin lymphoma patient. BMJ CaseReports : Jan 2013. Available from: URL: http://dx.doi.org/10.1136/bcr-2013-008894 - USA 803091368
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Reactions 17 Aug 2013 No. 14650114-9954/13/1465-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
