Abstract
We report a case of typhlitis as the initial presentation of adult acute lymphocytic leukemia (ALL). A forty-five year old man presented with fever, right lower quadrant pain and diarrhea. On admission the hemogram revealed 67% blast cells in the peripheral blood. A cytochemical study confirmed a diagnosis of ALL. The absolute neutrophil count dropped to 117 three days later. Abdominal computerized tomography showed that the colon was swollen on the right side with an abnormally thickened wall and infiltrations in the pericolic fat. Stool analysis was positive for occult blood and Giardia lamblia. Typhlitis complicating ALL was considered and empirical antibiotics (ceftazidime and metronidazole) which covered Gram negative bacilli, anaerobic bacteria and Giardia lamblia were instituted. The typhilitis symptoms improved and a follow-up abdominal MRI study showed complete resolution of right side colon disease. Standard chemotherapy for ALL (vincristine, daunorubicin, L-asparaginase, prednisolone and intrathecal methotrexate) was given. Unfortunately the patient died after a sudden onset of ventricular fibrillation during an episode of pneumonia. We suggest that typhlitis may present as an initial manifestation of ALL and Giardia lamblia may play a role in its pathogenesis.
| Original language | English |
|---|---|
| Journal | Tzu Chi Medical Journal |
| Volume | 18 |
| Issue number | 2 |
| Publication status | Published - Apr 1 2006 |
| Externally published | Yes |
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Keywords
- Acute lymphocytic leukemia
- Giardia lamblia
- Neutropenic enterocolitis
- Typhlitis
ASJC Scopus subject areas
- Medicine(all)
Cite this
Typhlitis as the initial presentation of acute lymphocytic leukemia - A case report. / Chen, Ming Cheh; Lin, Hans Hsienhong; Yi, Chih Hsun; Chen, Chien Lin; Huang, Lu Chin; Kao, Ruey Ho.
In: Tzu Chi Medical Journal, Vol. 18, No. 2, 01.04.2006.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Typhlitis as the initial presentation of acute lymphocytic leukemia - A case report
AU - Chen, Ming Cheh
AU - Lin, Hans Hsienhong
AU - Yi, Chih Hsun
AU - Chen, Chien Lin
AU - Huang, Lu Chin
AU - Kao, Ruey Ho
PY - 2006/4/1
Y1 - 2006/4/1
N2 - We report a case of typhlitis as the initial presentation of adult acute lymphocytic leukemia (ALL). A forty-five year old man presented with fever, right lower quadrant pain and diarrhea. On admission the hemogram revealed 67% blast cells in the peripheral blood. A cytochemical study confirmed a diagnosis of ALL. The absolute neutrophil count dropped to 117 three days later. Abdominal computerized tomography showed that the colon was swollen on the right side with an abnormally thickened wall and infiltrations in the pericolic fat. Stool analysis was positive for occult blood and Giardia lamblia. Typhlitis complicating ALL was considered and empirical antibiotics (ceftazidime and metronidazole) which covered Gram negative bacilli, anaerobic bacteria and Giardia lamblia were instituted. The typhilitis symptoms improved and a follow-up abdominal MRI study showed complete resolution of right side colon disease. Standard chemotherapy for ALL (vincristine, daunorubicin, L-asparaginase, prednisolone and intrathecal methotrexate) was given. Unfortunately the patient died after a sudden onset of ventricular fibrillation during an episode of pneumonia. We suggest that typhlitis may present as an initial manifestation of ALL and Giardia lamblia may play a role in its pathogenesis.
AB - We report a case of typhlitis as the initial presentation of adult acute lymphocytic leukemia (ALL). A forty-five year old man presented with fever, right lower quadrant pain and diarrhea. On admission the hemogram revealed 67% blast cells in the peripheral blood. A cytochemical study confirmed a diagnosis of ALL. The absolute neutrophil count dropped to 117 three days later. Abdominal computerized tomography showed that the colon was swollen on the right side with an abnormally thickened wall and infiltrations in the pericolic fat. Stool analysis was positive for occult blood and Giardia lamblia. Typhlitis complicating ALL was considered and empirical antibiotics (ceftazidime and metronidazole) which covered Gram negative bacilli, anaerobic bacteria and Giardia lamblia were instituted. The typhilitis symptoms improved and a follow-up abdominal MRI study showed complete resolution of right side colon disease. Standard chemotherapy for ALL (vincristine, daunorubicin, L-asparaginase, prednisolone and intrathecal methotrexate) was given. Unfortunately the patient died after a sudden onset of ventricular fibrillation during an episode of pneumonia. We suggest that typhlitis may present as an initial manifestation of ALL and Giardia lamblia may play a role in its pathogenesis.
KW - Acute lymphocytic leukemia
KW - Giardia lamblia
KW - Neutropenic enterocolitis
KW - Typhlitis
UR - http://www.scopus.com/inward/record.url?scp=33745098326&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745098326&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:33745098326
VL - 18
JO - Tzu Chi Medical Journal
JF - Tzu Chi Medical Journal
SN - 1016-3190
IS - 2
ER -