Neutropenic Fever Secondary to Concurrent Clostridioides difficile Infection and Neutropenic Enterocolitis

Neutropenic enterocolitis (NE), also known as typhlitis, is a life-threatening condition that typically occurs in individuals with severe neutropenia, particularly following recent chemotherapy. It carries a high mortality rate, making rapid identification and treatment essential to prevent serious complications or death. The pathogenesis of NE is not fully understood but is believed to be multifactorial. It involves a sequence of events including cytotoxic drug-induced mucosal injury, microbial invasion of the colonic mucosa, and bowel wall necrosis, all occurring in the context of profound neutropenia, ultimately leading to the clinical manifestation of NE. The resulting colonic wall inflammation makes the bowel highly susceptible to infection by various bacterial and/or fungal pathogens. Common clinical features include neutropenic fever, abdominal pain, diarrhea, and rectal bleeding. Early recognition, initiation of appropriate antibiotic therapy, and supportive care are critical for improving outcomes. In this report, we present the case of a patient with newly diagnosed non-Hodgkin lymphoma who presented with persistent watery diarrhea and was found to have neutropenic fever secondary to concurrent Clostridioides difficile infection and NE.