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At least 235 records · Page 13Linked to original sources
PubMed2001

Salmonella excretion after cessation of tosufloxacin therapy in acute nontyphoid salmonella enterocolitis.

Symptomatic nontyphoid salmonella enterocolitis patients were treated with tosufloxacin (TFLX) at oral doses of 150 mg three times a day for 5 to 7 days, but bacterial relapse without symptoms occurred in 85% of the patients within 15 days after the cessation of therapy. Our study indicates that TFLX may not be an ideal drug against symptomatic salmonella enterocolitis from a bacteriological point of view.

Administration, Oral↗
PubMed2003

Neutropenic enterocolitis: a serious complication during the treatment of acute leukemias.

Neutropenic enterocolitis (NE) is a severe gastrointestinal complication in patients who undergo aggressive chemotherapy. It is a necrotizing inflammation of the cecum, colon, and the terminal part of the ileum. The serious clinical state of NE patients requires very frequent surgical consultations; however, in a few particular cases of NE, e.g., perforation of the bowels, a surgical intervention is necessary. Here, we report on six cases of NE in patients with acute leukemias. The patients were all women aged 21-55 years. Two of them had acute myeloid leukemia and four had lymphoblastic leukemia. NE occurred 7-10 days after the completion of chemotherapy, during the neutropenic phase. They represented a typical picture of NE: two of them died because of septic shock; five patients had subileus with irritation of the peritoneum; and one had hepatosplenic abscesses confirmed 6 months later by post-mortem examination. In each case, a surgical opinion was required. None of these patients were operated on. We present a report summarizing our experience and problems with six patients who had a clinical picture of NE and offer a short review of the current literature on the subject.

Abdominal Neoplasms↗
PubMed2005

Prevalence of ischemic enterocolitis in patients with acute pancreatitis.

BACKGROUND: A considerable number of acute pancreatitis cases have been reported to be complicated by nonocclusive mesenteric ischemia. However, no reports have ever referred to the incidence of ischemic enterocolitis in patients with acute pancreatitis, using a series of autopsy cases. Here, we report our review of autopsy cases of patients with acute pancreatitis to examine the incidence of associated ischemic enterocolitis. METHODS: The intestinal and pancreatic slides of 48 autopsy cases of patients with acute pancreatitis were reviewed and the incidence of ischemic enterocolitis was determined. Clinical case records were also reviewed. RESULTS: Thirteen (27%) of 48 autopsy cases of patients with acute pancreatitis were complicated by ischemic enterocolitis. The frequency of shock was significantly higher in patients with ischemic enterocolitis than in those without ischemic enterocolitis. The intestinal lesion was diffuse in many cases and gangrene was not an unusual finding. CONCLUSIONS: The incidence of ischemic enterocolitis in patients with acute pancreatitis was much higher than that in the previous reports. Clinicians who treat patients with acute pancreatitis should consider ischemic enterocolitis as one of the frequent and severe complications of this condition.

Acute Disease↗
PubMed2000

Successful conservative treatment of neutropenic enterocolitis complicating taxane-based chemotherapy: a report of five cases.

Five cases of acute neutropenic enterocolitis complicating taxane-based chemotherapy are described. During a 34-month period, our department administered 4,600 courses of taxane-based (paclitaxel and docetaxel) chemotherapy to 800 cancer patients. Seven to 10 days postchemotherapy in five patients (0.1% of the given courses), neutropenic fever, abdominal pain, rebound tenderness, and grade II-IV diarrhea (bloody in two cases) developed. Two patients had oral candidiasis, and in two others septic shock developed. Computed tomography scans of the abdomen revealed in all patients thickening of the colon wall and pericolic edema, and a pericolic abscess was revealed in three of them. Both clinical and radiologic findings supported the diagnosis of acute neutropenic enterocolitis. All patients were successfully treated with broad-spectrum antibiotics and recombinant human granulocyte colony-stimulating factor. In conclusion, acute neutropenic enterocolitis is a severe complication of taxane-based chemotherapy. Early diagnosis and appropriate conservative treatment leads to complete recovery. Although rare, this infection is less often associated with other chemotherapeutic regimens.

Acute Disease↗
PubMed1991

[Acute kidney failure as a "mask" of a dissecting aortic aneurysm].

Two cases--of a 52-year-old man and a 59-year-old woman--are presented. The onset of the disease was acute with diarrheal syndrome and the patients were hospitalized in the Infectious Disease Clinic. The diagnosis of acute infectious enterocolitis was rejected. In the first days after the hospitalization the patients became oligoanuric and increased levels of urea and creatinine were established. A diagnosis of acute renal failure after acute enterocolitis was made and the patients were transferred to the Nephrologic Clinic. In spite of the rapid restoration of the diuresis after i.v. infusions, the patients died suddenly. The postmortem examination revealed an aortic dissecting aneurysm.

Acute Kidney Injury↗
PubMed2001

Neutropenic enterocolitis in patients with acute leukemia: prognostic significance of bowel wall thickening detected by ultrasonography.

PURPOSE: Neutropenic enterocolitis (NE) is a severe complication of intensive chemotherapy and is barely identifiable by clinical signs alone. Ultrasonography (US) supports the diagnosis of NE by showing pathologic thickening of the bowel wall. The aim of this study was to evaluate the prognostic value of the degree of mural thickening evaluated by US in patients with clinically suspected NE. PATIENTS AND METHODS: Neutropenic patients with fever, diarrhea, and abdominal pain after intensive chemotherapy for hematologic malignancies were studied with abdominal US. We evaluated the degree of bowel wall thickening detected by US and its correlation with the duration of the clinical syndrome as well as NE-related mortality. RESULTS: Eighty-eight (6%) of 1,450 consecutive patients treated for leukemia had clinical signs of NE. In 44 (50%) of 88 patients, US revealed pathologic wall thickening (mean +/- SD, 10.2 +/- 2.9 mm; range, 6 to 18). The mean duration of symptoms was significantly longer in this group (7.9 days) than among patients without mural thickening (3.8 days, P <.0001), and the NE-related mortality rate was higher (29.5% v 0%, P <.001). Patients with bowel wall thickness of more than 10 mm had a significantly higher mortality rate (60%) than did those with bowel wall thickness < or = 10 mm (4.2%, P <.001). CONCLUSION: Symptomatic patients with sonographically detected bowel wall thickening have a poor prognosis compared with patients without this finding. In addition, mural thickness of more than 10 mm is associated with poorer outcome among patients with NE.

Acute Disease↗
PubMed1987

Successful medical management of neutropenic enterocolitis in adults with acute leukemia.

Seven adults with acute leukemia had a clinical and radiologic diagnosis of neutropenic enterocolitis. Six of the seven patients had granulocyte counts less than 500/microliter. All seven patients responded to intensive medical therapy, including bowel rest, broad spectrum antibiotics, and white blood cell transfusions, and recovered from the neutropenic enterocolitis without surgical intervention. We discuss the clinical spectrum of neutropenic enterocolitis and the favorable results of medical therapy.

Adult↗
PubMed2003

Fatal Bacillus cereus sepsis following resolving neutropenic enterocolitis during the treatment of acute leukemia.

Bacillus cereus is increasingly being acknowledged as a serious bacterial pathogen in immunosuppressed hosts. We report a case of fatal B. cereus sepsis in a patient with newly diagnosed acute leukemia following resolving neutropenic enterocolitis. Gastrointestinal complaints are common during induction chemotherapy, yet some antimicrobial coverage suitable for generalized neutropenia is not optimal for the eradication of B. cereus. This case demonstrates that, in the neutropenic patient with gastrointestinal complaints or in the setting of resolving neutropenic enterocolitis, it is important to anticipate possible B. cereus infection and sepsis.

Adult↗