Document Detail


Necrotizing enterocolitis in neutropenia and chemotherapy: a clinical update and old lessons relearned.
MedLine Citation:
PMID:  16836946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neutropenic enterocolitis (NE) must be recognized in patients with fever, neutropenia, and abdominal pain. Classically, NE has been described in patients with hematologic malignancies treated with intensive chemotherapy. Current interest in NE has increased due to recent cases associated with newer, more intensive chemotherapy in solid tumors. This review discusses pathology, clinical presentation, and treatment of NE. Ultrasonography or CT scans are the best radiographic studies to confirm the diagnosis. Management options, including antimicrobial therapy, surgery, and supportive care, are discussed. Chemotherapy incorporating the taxane family of drugs (paclitaxel and docetaxel) associated with NE is also reviewed with observations regarding the earlier onset of the disease in the first weeks following chemotherapy. Even with currently recommended therapy, a high mortality rate, approximating 45%, can occur. Best outcomes for NE rely upon understanding of risks for the condition, prompt empiric therapy with broad-spectrum antimicrobial agents, systemic antifungal therapy, and meticulous attention to supportive care.
Authors:
CelesteAnn T Bremer; Brian P Monahan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current gastroenterology reports     Volume:  8     ISSN:  1522-8037     ISO Abbreviation:  Curr Gastroenterol Rep     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-13     Completed Date:  2006-08-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888896     Medline TA:  Curr Gastroenterol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  333-41     Citation Subset:  IM    
Affiliation:
Division of Hematology, Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4217, USA.
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / adverse effects*,  therapeutic use
Bridged Compounds / adverse effects*,  therapeutic use
Diagnosis, Differential
Enterocolitis, Necrotizing / diagnosis*,  drug therapy
Humans
Incidence
Neutropenia / chemically induced*,  diagnosis,  epidemiology
Risk Factors
Taxoids / adverse effects*,  therapeutic use
World Health
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Bridged Compounds; 0/Taxoids; 1605-68-1/taxane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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