neutropenic colitis

中性粒细胞减少性结肠炎
  • 文章类型: Case Reports
    中性粒细胞减少性小肠结肠炎(NEC),也被称为伤寒,是一种与高死亡率风险相关的疾病,主要表现在免疫功能低下的患者中。它的特点是溃疡,水肿,出血影响肠壁.NEC的根本原因被假定为促进细菌通过受损肠粘膜浸润的免疫受损病症。高死亡率归因于肠坏死,最终导致穿孔和败血症。该报告描述了一例涉及转移性精原细胞瘤的患者,该患者表现出癫痫样活动,发烧,溶胆链球菌菌血症,和NEC。患者接受了包括广谱抗生素和非格司亭的治疗。患者的中性粒细胞减少症消退,导致口服抗生素出院。报告的病例是独特的,因为它将NEC与溶胆链球菌和精原细胞瘤联系起来。溶胆链球菌以前与NEC无关。
    Neutropenic enterocolitis (NEC), also referred to as typhlitis, is a condition associated with a high mortality risk and primarily manifests in immunocompromised patients. It is characterized by ulceration, edema, and hemorrhage affecting the bowel wall. The underlying cause of NEC is postulated as an immunocompromised condition that facilitates bacterial infiltration through compromised bowel mucosa. The high mortality rate is attributable to bowel necrosis, culminating in perforation and sepsis. This report describes a case involving a patient with metastatic seminoma who exhibited seizure-like activity, fever, Streptococcus gallolyticus bacteremia, and NEC. The patient underwent treatment involving broad-spectrum antibiotics and filgrastim. The patient\'s neutropenia resolved leading to discharge on oral antibiotics. The case reported is unique, as it links NEC to Streptococcus gallolyticus and seminoma. Streptococcus gallolyticus has not been previously associated with NEC.
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  • 文章类型: Case Reports
    中性粒细胞减少性小肠结肠炎(NE)是一种罕见但严重的并发症,发生在接受强化化疗的中性粒细胞减少患者中。死亡率很高,所以需要早期诊断才能开始紧急医疗或手术治疗。造血干细胞移植后NE发展的数据分析仍然很少。本病例系列的目的是讨论2016年至2020年在CheikhKhalifa国际大学医院血液科接受自体干细胞移植(ASCT)治疗多发性骨髓瘤合并NE的100名患者中的5名。卡萨布兰卡,摩洛哥。患者诊断为IgA和IgG多发性骨髓瘤,年龄在58至64岁之间。他们接受了包括蛋白酶体抑制剂在内的三联疗法的四个周期的诱导治疗,一种免疫调节药物,和皮质类固醇,允许完全缓解。强化基于使用200mg/m2的美法仑的ASCT。发育期的标志是NE的突然出现,根据临床诊断,生物,和成像标准。治疗包括抗生素治疗和支持治疗。我们报告病例没有并发症,也不需要手术治疗.因此,我们认为早期诊断和治疗可以在我们的病例系列中取得良好的进展。NE的管理必须是多学科的血液学家,胃肠病学家,放射科医生,和生物学家。需要更多的研究和试验来建立具体的诊断标准和更好的治疗方案。
    Neutropenic enterocolitis (NE) is a rare but severe complication occurring in neutropenic patients undergoing intensive chemotherapy. Mortality is high, so early diagnosis is required to start urgent medical or surgical treatment. Data analysis of the development of NE after hematopoietic stem cell transplantation remains scarce. The aim of this case series is to discuss five out of 100 patients receiving autologous stem cell transplants (ASCTs) for multiple myeloma complicated with NE between 2016 and 2020 in the hematology department of the Cheikh Khalifa International University Hospital, Casablanca, Morocco. The patients were diagnosed with IgA and IgG multiple myeloma and aged between 58 to 64 years. They received induction therapy with four cycles of a triplet regimen including a proteasome inhibitor, an immunomodulatory drug, and corticosteroids, allowing a complete remission. Intensification was based on ASCT with melphalan at 200 mg/m2. The period of aplasia was marked by the sudden appearance of NE, diagnosed based on clinical, biological, and imaging criteria. Treatment included antibiotherapy and supportive care. We report no complications in our cases, nor the need for surgical care. Therefore, we consider that early diagnosis and treatment allowed a good evolution in our case series. The management of NE must be multidisciplinary associating hematologists, gastroenterologists, radiologists, and biologists. More studies and trials are needed to establish specific diagnostic criteria and better treatment options.
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  • 文章类型: Case Reports
    伤寒,也被称为中性粒细胞减少性小肠结肠炎,是一种罕见但严重的疾病,其特征是盲肠发炎,导致右下腹(RLQ)疼痛和发烧。它通常影响免疫功能低下的中性粒细胞减少症患者,恶性血液病,艾滋病,或者那些接受免疫抑制治疗的人.对于发热性RLQ疼痛的患者,这是一个应该考虑的实体,不仅仅是那些有明显免疫抑制的人。
    Typhlitis, also known as neutropenic enterocolitis, is a rare but serious condition characterized by inflammation of the cecum causing right lower quadrant (RLQ) pain and fever. It typically affects immunocompromised patients with neutropenia, hematologic malignancies, AIDS, or those on immunosuppressive therapy. This is an entity that should be considered in any differential for a patient with febrile RLQ pain, not just those with obvious immunosuppression.
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  • 文章类型: Case Reports
    Invasive fungal infections constitute a major cause of morbidity and mortality in children undergoing therapy for hematological malignancies. We report a 1-year-old boy who was receiving chemotherapy for acute lymphoblastic leukemia. His clinical course was complicated by a clinical syndrome consistent with neutropenic enterocolitis to which he succumbed. Histopathology of the surgically resected bowel revealed evidence of mucormycosis. Gastrointestinal mucormycosis is an unusual presentation which requires high degree of clinical suspicion and aggressive management.
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  • 文章类型: Journal Article
    Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury (mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. This article aims to review current concepts regarding neutropenic colitis\' pathogenesis, diagnosis, and management.
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  • 文章类型: Journal Article
    Right lower quadrant pain is one of the most common indications for imaging evaluation of the abdomen in the emergency department setting. This article reviews important imaging findings associated with acute appendicitis as well as major differential considerations including: mesenteric adenitis, Meckel diverticulum, neutropenic colitis, right-sided diverticulitis, epiploic appendagitis, omental infarction, and inflammatory bowel diseaseRight lower quadrant pain is one of the most common indications for imaging evaluation of the abdomen in the emergency department setting. This article reviews important imaging findings associated with acute appendicitis as well as major differential considerations including: mesenteric adenitis, Meckel diverticulum, neutropenic colitis, right-sided diverticulitis, epiploic appendagitis, omental infarction, and inflammatory bowel disease.
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