NEUTROPENIC ENTEROCOLITIS - 2 UNUSUAL CASES WITH REVIEW OF THE LITERATURE

Cases of neutropenic enterocolitis associated with Clostridium septicu m infection have been reported with increasing frequency in the past d ecade. We report two such cases involving unusual hosts and briefly di scuss possible pathogenetic mechanisms such as ischemia, mucosal damag e related to chemotherapy and neutropenia, and immunosuppression. One case involved a young man with chronic Epstein-Barr infection who deve loped extensive gas gangrene of the right side of his trunk and thigh and who died within 12 hours of presentation to the emergency departme nt. Diagnosis was only made at postmortem examination. The second, mid dle-aged patient was admitted with an acute abdomen shortly after he c ompleted chemotherapy for pleural mesothelioma. A right hemicolectomy was performed, but the patient developed antibiotic-associated pseudom embranous colitis and died. These cases indicate that neutropenic ente rocolitis may arise in a variety of underlying conditions and that pro mpt diagnosis and therapy will be required to salvage more patients wi th this disorder.