COVID-19-associated pancytopenia and typhlitis

Area of Science:

• Gastroenterology
• Infectious Diseases
• Hematology

Background:

• Neutropenic enterocolitis, or typhlitis, involves severe bowel inflammation, often in immunocompromised individuals, carrying high morbidity and mortality.
• Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) primarily targets the respiratory system but can impact hematopoietic and gastrointestinal functions.

Observation:

• A 60-year-old female presented with abdominal pain, later diagnosed with pancytopenia and typhlitis.
• Contrast-enhanced abdominal CT revealed bowel wall thickening in the cecum and ascending colon, indicative of enterocolitis.
• Chest CT showed bilateral ground-glass opacities, consistent with COVID-19 pneumonia.

Findings:

• The patient exhibited a rare combination of COVID-19-associated pancytopenia and typhlitis.
• Diagnostic imaging confirmed both COVID-19 pneumonia and enterocolitis.
• Laboratory, clinical, and CT findings were crucial in diagnosing this complex presentation.

Implications:

• This case underscores the potential for SARS-CoV-2 to cause significant gastrointestinal complications beyond respiratory symptoms.
• It highlights the importance of considering COVID-19 in patients presenting with typhlitis and pancytopenia.
• Further research may elucidate the mechanisms linking SARS-CoV-2 to gastrointestinal and hematologic disturbances.