Clostridial species in the pathogenesis of necrotizing enterocolitis in patients with neutropenia

Abstract

The role of gram-negative bacteria in the pathogenesis of necrotizing enterocolitis has been stressed. We describe a 21-year-old woman with chronic neutropenia with cyclic fluctuations who died of necrotizing enterocolitis due to Clostridium septicum. Seven patients with cyclic neutropenia and necrotizing enterocolitis have been described in the literature and in each case in which bacteriologic data were reported, a Clostridial infection was documented. Patients with cyclic neutropenia should be treated with antibiotics effective against Clostridial species when abdominal symptoms complicate neutropenic periods.

Neutropenic Enterocolitis: Spectrum of the Disease and Comparison of Definite and Possible Cases

“…Local intramural hemorrhages or infiltration by the underlying malignancy usually produces focal wall thickening sive treatment for acute leukemia and less frequently in patients with solid tumors; however, it can also develop in subjects instead of diffuse colitis [11], but these conditions are much less frequent than NEC. with primary marrow failure unrelated to chemotherapy, such as in cyclic neutropenia and aplastic anemia [2,3]. The cecum…”

“…It reviewed. In addition, the records of all neutropenic patients who had these same symptoms during this same time period can also develop in individuals with aplastic anemia or cyclic neutropenia who have not received cytotoxic treatment [2]. at the Hospital de Sant Pau (Barcelona) were reviewed.…”

Painless Neutropenic Enterocolitis in a Patient Undergoing Chemotherapy

“…The clinical hallmarks of ne include fever and abdominal pain, but abdominal distention, bloating, and diarrhea have also been reported as associated signs and symptoms 4,5 . Neutropenic enterocolitis is most commonly reported to affect patients undergoing chemotherapy, but it has also been seen in patients who develop neutropenia in other conditions such as chronic neutropenia and infection with hiv 6,7 . When ne is suspected, the diagnosis is made by ct imaging, which can show pericecal fluid and bowel wall thickening 3 .…”

Surgical Aspects of Clostridium septicum Septicemia

“…These have included six with granulocytopenia, one with preleukemia, one with chronic idiopathic granulocytopenia, three with cyclic neutropenia, two with agranulocytosis, and one with chronic neutropenia. Four of these manifested necrotizing enterocolitis.10, 13,14 Although it is believed that C septicum is a normal inhabitant of the gastrointestinal tract,1,42 recent studies have not confirmed this.2,3,43 Nevertheless, the gastroin¬ testinal tract has been the presumed portal of entry of the infecting organism in the vast majority of these cases. The common feature in these infections has been a break in the normal gastrointestinal mucosa.…”