Severe abdominal infections in neutropenic patients

Abdominal infections are an important cause of morbidity and mortality in n eutropenic patients. We present a retrospective series of 16 patients, most ly with acute leukemia, who developed severe abdominal infections during ch emotherapy-induced neutropenia between 1991 and 1997. The frequency among p atients with acute leukemia was 2.35% (13 of 553). Thirteen patients presen ted with enterocolitis and 3 patients presented with cholecystitis. Eight p atients died. Bacteremia was present in 6 patients, 4 patients suffered fro m proven or strongly suspected fungal infections, and I patient suffered fr om cytomegalovirus infection. Early surgical management was required in a p atient with intestinal obstruction, whereas other patients could be managed conservatively. Two patients with acute cholecystitis were treated with an tibiotics until the end of neutropenia and then were resected. Severe abdom inal infections in neutropenic patients, which are often fatal, were caused by nonbacterial microorganisms in one-fourth of the cases and could be man aged conservatively, in most instances.