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Typhlitis in childhood cancer
M Beth McCarville1, C Scott Adelman, Chenghong Li
1Division of Diagnostic Imaging, Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. beth.mccarville@st jude.org
Cancer
|June 14, 2005
Summary
Typhlitis in children undergoing chemotherapy is often characterized by abdominal pain and fever, and may occur without neutropenia. Ultrasonography is useful for diagnosis, with severity linked to neutropenia duration.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Medical Imaging
Background:
- Typhlitis, a recognized complication in pediatric chemotherapy patients, requires further characterization.
- This study investigates demographic, clinical, and imaging factors influencing typhlitis diagnosis, risk, and outcomes.
Purpose of the Study:
- To characterize typhlitis in children undergoing chemotherapy.
- To identify demographic, clinical, and imaging predictors of typhlitis.
- To assess risk factors and outcomes associated with typhlitis.
Main Methods:
- Retrospective review of 3171 pediatric patients treated between 1990-2001.
- Analysis of demographic data, clinical presentation, and imaging (ultrasonography, CT) for 83 typhlitis cases.
- Comparison of patients with typhlitis versus a control group to identify risk factors.
Main Results:
- Typhlitis occurred in 2.6% of patients; common symptoms included abdominal pain, fever, and diarrhea.
- Neutropenia was absent in 12% of cases; ultrasonography correlated with typhlitis duration (P=0.05).
- Age over 16 at diagnosis was the sole demographic risk factor (P=0.03); severity linked to neutropenia duration and fever/tenderness.
Conclusions:
- Ultrasonography is a valuable imaging tool for suspected pediatric typhlitis.
- The classic symptoms of typhlitis (fever, abdominal pain, neutropenia) may not all be present.
- Typhlitis severity correlates with neutropenia duration and the presence of fever or abdominal tenderness.