Neutropenic enterocolitis (typhlitis) associated with infectious mononucleosis

Area of Science:

• Gastroenterology
• Pediatric Infectious Diseases
• Hematology

Background:

• Neutropenic enterocolitis (typhlitis) is an acute abdominal complication typically seen in neutropenic patients undergoing chemotherapy for hematologic malignancies.
• It is characterized by inflammation, ulceration, and potential necrosis of the colon, primarily the cecum and ascending colon.
• Risk factors include neutropenia, cytotoxic therapy, and prolonged hospitalization.

Observation:

• A unique case of an 8-year-old girl with a recent diagnosis of infectious mononucleosis is presented.
• The patient exhibited clinical and radiological findings suggestive of typhlitis on abdominal computed tomography (CT).
• This presentation is unusual as infectious mononucleosis is not a commonly recognized cause of neutropenia leading to typhlitis.

Findings:

• Abdominal CT revealed segmental ulceration and inflammation in the cecum and ascending colon, consistent with typhlitis.
• The patient's neutropenia was linked to her infectious mononucleosis, a less common etiology for this condition.
• This case demonstrates the potential for typhlitis to occur in the context of viral infections causing neutropenia.

Implications:

• This case expands the known spectrum of conditions associated with neutropenic enterocolitis.
• It suggests that infectious mononucleosis should be considered in the differential diagnosis of typhlitis in pediatric patients presenting with neutropenia.
• Further investigation may be warranted to understand the mechanisms linking viral infections like infectious mononucleosis to typhlitis.