Typhlitis in a Leukemia Patient：A Case Report

Abstract

Acute abdominal pain is the biggest challenge for doctors in an emergency department (ED). A leukemia patient who had had three courses of chemotherapy visited our ED with right lower quadrant (RLQ) abdominal pain. We diagnosed his condition as acute appendicitis and an appendectomy was performed. Unfortunately, the abdominal pain recurred, so the patient underwent abdominal computed tomography. We concluded this was a case of typhlitis. An initial diagnosis of appendicitis is normally based on clinical features. When a patient who has been receiving chemotherapy presents with neutropenia together with RLQ abdominal pain, fever, diarrhea, or hematochezia, one should consider this diagnosis and confirm the diagnosis with a radiological investigation. Physicians are reminded that when an emergent condition with acute RLQ abdominal pain occurs in immune compromised patients, the possibility of typhlitis should be included in the differential diagnosis.