Potentially life-threatening emergency
Neutropenic enterocolitis
Alerts and Notices
Synopsis
Patients with leukemia undergoing cytotoxic chemotherapy are at highest risk for neutropenic enterocolitis. This was initially appreciated in pediatric patients but is seen in adults as well. Any patient with chemotherapy-induced neutropenia is at an increased risk for neutropenic enterocolitis.
Neutropenic enterocolitis commonly presents with right lower quadrant abdominal pain, diarrhea, and fever with underlying neutropenia or immune compromise. Patients can develop severe sepsis with end-organ damage and bowel perforation with progressive neutropenic enterocolitis. Early recognition and treatment of sepsis with intravenous antibiotics and volume resuscitation, along with surgical intervention if necessary, are the hallmarks of treatment that can improve mortality. If untreated, neutropenic enterocolitis can be fatal.
Codes
ICD10CM:K52.9 – Noninfective gastroenteritis and colitis, unspecified
SNOMEDCT:
240358005 – Neutropaenic enterocolitis
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Acute appendicitis
- Appendiceal abscess
- Graft-versus-host disease
- Viral, bacterial, or parasitic gastroenteritis (including cytomegalovirus, norovirus, Clostridioides difficile colitis)
- Ischemic colitis
- Colonic pseudo-obstruction
- Acute mesenteric ischemia
- Acute viral hepatitis
- Choledocholithiasis
- Ascending cholangitis
- Acute cholecystitis / acalculous cholecystitis
- Acute pancreatitis
- Bowel obstruction (small or large intestine)
- Diverticulitis
- Inflammatory bowel disease (Crohn disease or ulcerative colitis)
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:03/27/2018
Last Updated:11/01/2022
Last Updated:11/01/2022
Potentially life-threatening emergency
Neutropenic enterocolitis