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Neutropenic enterocolitis associated with Clostridium tertium
Journal of Clinical Pathology
|February 1, 1993
Summary
A severe case of neutropenic enterocolitis in a teenage leukemia patient was linked to Clostridium tertium infection. This is the first documented instance of this specific bacterial cause for the condition.
Area of Science:
- Medical Microbiology
- Gastroenterology
- Pediatric Oncology
Background:
- Neutropenic enterocolitis (NE), also known as typhlitis, is a serious gastrointestinal complication in immunocompromised patients.
- Acute lymphoblastic leukemia (ALL) treatment often leads to neutropenia, increasing the risk of NE.
- Empirical antibiotic treatment is standard for suspected NE, but resistance and novel pathogens pose challenges.
Observation:
- A 15-year-old boy with relapsed ALL presented with severe diarrhea and abdominal pain.
- Symptoms persisted despite broad-spectrum antibiotic therapy.
- Surgical intervention revealed characteristic features of neutropenic enterocolitis in the cecum and ascending colon.
Findings:
- Clostridium tertium was identified as the sole causative organism.
- The bacterium was isolated from fecal samples, blood cultures, and the resected intestinal tissue.
- This marks the first reported association between documented Clostridium tertium infection and neutropenic enterocolitis.
Implications:
- Highlights Clostridium tertium as a potential pathogen in neutropenic enterocolitis.
- Suggests the need for broader diagnostic considerations beyond common pathogens in refractory NE cases.
- Informs clinical management strategies for gastrointestinal complications in pediatric oncology patients.