Neutropenic colitis gems

From memory:

1. Neutropenic colitis occurs in neutropenic patients
2. Mimics appendicitis (trap!)
3. Don't call it typhlitis, as it falsely suggest that it can only occur in the cecum
4. A concomitant C diff infection worsens prognosis 
5. Broad spectrum antibiotics including flagyl
6. Best solution, normalize WBC

From reading "neutropenic colitis in children":

Neutropenic colitis was found in 1.4% of children treated for a malignant condition. Although the majority of patients were profoundly neutropenic (Mean ANC = 164), 12% had a normal neutrophil count. The episode of colitis, which presents with vague signs and symptoms, is usually preceded by a precipitous drop in ANC.

Although most cases involve the cecum, the colitis may involve the ascending colon, and even the terminal ileum.

Treatment involves bowel rest, decompression, broad spectrum antibiotics (including anti-fungals), and occasionally G-CSF. Operative management is reserved for patients with bowel perforation, bleeding, or clinical deterioration.

So learned a couple of things today.