Acute Appendicitis in a Child With Acute Leukemia and Chemotherapy-Induced Neutropenia: A Case Report and Literature Review

Abstract

Acute appendicitis is a rare but important complication in children with leukemia. It can be difficult to diagnose, and it has a complicated disease course, especially in patients receiving chemotherapy. Awareness of these complications is critical, particularly in cases where surgical intervention is required. We report a child with T-cell acute lymphoblastic leukemia and chemotherapy-induced neutropenia who presented with acute appendicitis. He was successfully treated with broad-spectrum empiric antibiotics and a delayed laparoscopic appendectomy.

Gut and liver involvement in pediatric hematolymphoid malignancies

“…Initial empiric coverage for antifungal agents is not routinely recommended but they can be considered if the initial therapy does not show optimal response in 72 h[ 11 ]. Indications for surgery include bowel perforation, uncontrolled massive GI bleeding, abscess or appendicitis which occurs in 0.5%-1.5% of patients[ 11 , 19 ].…”

Management of acute appendicitis in pediatric patients with acute leukemia: Insights from a single‐center study

“…3,8 Furthermore, any delay in recovering from AA can result in the postponement of chemotherapy or alterations in chemotherapeutic regimens, potentially leading to leukemia relapse. 9,10 The literature on AA in children with AL is scarce and is comprised of case reports and a few retrospective studies. 4,6,9,10 We describe our single-center experience in managing pediatric patients who developed AA either at the onset of their AL diagnosis or during their leukemia treatment.…”

“…9,10 The literature on AA in children with AL is scarce and is comprised of case reports and a few retrospective studies. 4,6,9,10 We describe our single-center experience in managing pediatric patients who developed AA either at the onset of their AL diagnosis or during their leukemia treatment.…”

Escalated doses of methotrexate and L‐asparaginase in critically ill children with a concurrent diagnosis of acute lymphoblastic leukemia and appendicitis

“…Delaying or stopping chemotherapy is controversial, especially in newly diagnosed patients with HOD. [3][4][5][6] We present three cases of children simultaneously diagnosed with acute lymphoblastic leukemia (ALL) and complicated appendicitis.…”

“…Delaying or stopping chemotherapy is controversial, especially in newly diagnosed patients with HOD. [3][4][5][6] We present three cases of children simultaneously diagnosed with acute lymphoblastic leukemia (ALL) and complicated appendicitis.They were managed with appendectomy, and less toxic chemotherapy consisted of L-asparaginase 6000 IU/m 2 and escalating doses of methotrexate (50-200 mg/m 2 ) in 10 days intervals 7 (Table 1).…”