Zvizdic Zlatan, Jonuzi Asmir, Pilav Lejla, Sefic Pasic Irmina, Vranić Semir
Department of Pediatric Surgery, Clinical Center University of Sarajevo, Sarajevo, BIH.
Department of Pediatrics, Clinical Center University of Sarajevo, Sarajevo, BIH.
Cureus. 2024 Oct 16;16(10):e71636. doi: 10.7759/cureus.71636. eCollection 2024 Oct.
Neutropenic enterocolitis (NE) is a potentially life-threatening condition, primarily affecting neutropenic patients with hematologic malignancies. The clinical manifestations of NE in patients receiving antineoplastic drugs range from fever, diarrhea, nausea, vomiting, and abdominal pain to intestinal perforation and shock. We report the case of a 12-year-old boy with acute myelogenous leukemia, undergoing chemotherapy, who presented with an atypical case of NE. Due to numerous jejunal perforations and severe rectal bleeding, he experienced abdominal distension without any accompanying tenderness and the unexpected rapid onset of shock. Surgery was performed, and his postoperative course was uneventful. However, seven days later, Pseudomonas aeruginosa-induced sepsis made his condition rapidly worse due to severe neutropenia and thrombocytopenia. Despite intensive supportive therapy, the patient unfortunately passed away. NE remains a life-threatening complication in pediatric immunosuppressed leukemic patients. A high index of suspicion, prompt diagnosis, aggressive treatment with broad-spectrum antibiotics, and correction of fluid-electrolyte imbalances are crucial in reducing morbidity and mortality.
中性粒细胞减少性小肠结肠炎（NE）是一种可能危及生命的疾病，主要影响患有血液系统恶性肿瘤的中性粒细胞减少患者。接受抗肿瘤药物治疗的患者中，NE的临床表现从发热、腹泻、恶心、呕吐、腹痛到肠穿孔和休克不等。我们报告了一例12岁急性髓性白血病男孩的病例，该男孩正在接受化疗，出现了一例非典型NE。由于多处空肠穿孔和严重的直肠出血，他出现腹胀但无压痛，且意外迅速发生休克。进行了手术，术后过程顺利。然而，七天后，由于严重的中性粒细胞减少和血小板减少，铜绿假单胞菌引起的败血症使他的病情迅速恶化。尽管进行了强化支持治疗，患者不幸去世。NE仍然是儿科免疫抑制白血病患者中一种危及生命的并发症。高度的怀疑指数、及时诊断、用广谱抗生素积极治疗以及纠正水电解质失衡对于降低发病率和死亡率至关重要。
