Febrile neutropenia as the presenting sign of appendicitis in an adolescent with acute myelogenous leukemia

Pediatric Hematology and Oncology
Emel OzyurekNamik Ozbek

Abstract

The diagnosis and management of a surgical abdomen in patients with acute leukemia is quite difficult because of the complications and treatment of disease itself. A 13-year-old boy with acute myelogenous leukemia developed 2 episodes of febrile neutropenia during induction therapy. The second one was treated with a 5-day course of parenteral antimicrobial therapy, but the patient then presented with right lower quadrant abdominal tenderness, guarding, and rebound tenderness. Abdominal ultrasonography and computed tomography revealed appendicitis. Conservative medical management was unsuccessful, and appendectomy was performed 5 days after appendicitis was diagnosed. The patient's clinical manifestations resolved 5 days later. The case illustrates that fever may be the first manifestation of appendicitis in a child with acute myelogenous leukaemia who is neutropenic. Surgery is acceptable as first-line treatment in such cases.

References

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Citations

Aug 6, 2008·Bone Marrow Transplantation·F ForghieriG Torelli
Sep 1, 2006·Photomedicine and Laser Surgery
Jul 2, 2009·Surgical Infections·Brant W UlleryPhilip S Barie
Jul 2, 2009·Surgical Infections·Brant W UlleryPhilip S Barie
Mar 31, 2010·Leukemia & Lymphoma·Tyler L V GrayLillian Sung
Apr 26, 2011·The Journal of Surgical Research·Vincent E MortellaroShawn D St Peter
May 10, 2017·Journal of Pediatric Hematology/oncology·Alberto A ScarpaMarilyne Poiree
Dec 7, 2007·International Journal of Hematology·Bulent AliogluNamik Ozbek
Jul 20, 2016·World Journal of Gastroenterology : WJG·Elio CastagnolaAlfredo Guarino
Feb 23, 2020·Journal of Pediatric Hematology/oncology·Caileigh PudelaWilliam C Petersen

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