Typhlitis (Neutropenic Enterocolitis)

What Is Typhlitis (Neutropenic Enterocolitis)?

Typhoid fever is a bacterial infection caused by one of three types of bacteria: Salmonella typhi, Shigella dysenteriae or Yersinia pestis. These are all Gram negative bacteria which means they do not produce any protective layer against other microorganisms. They live in the intestines where they multiply rapidly and release toxins into the bloodstream causing severe inflammation and pain throughout the body. The disease usually begins with flu-like symptoms such as chills, fever, headache and muscle aches. After several days the person may develop diarrhea, vomiting blood and even bleeding from the nose or eyes. Some people die within a few weeks of contracting typhoid fever.

The most common symptom is abdominal cramps that last for many hours at a time. Other symptoms include nausea, vomiting blood and bloody stools. Sometimes the person will experience weakness, fatigue, loss of appetite and headaches. If left untreated, the patient may suffer from dehydration and shock.

In some cases of typhlitis (neutropenic enterocolitis), there is no fever at all. This condition is called asymptomatic or subclinical typhus. In other cases, the person develops a high fever which lasts for several days after contracting typhoid fever.

If you experience any of the following symptoms, you may have typhoid fever:

Runny nose

High fever that comes on suddenly

Fatigue and weakness


Loss of appetite

Muscle pain

Pain in abdomen or chest

Rash that appears a day or two after the onset of fever usually on the chest or stomach but it can also appear on the arms or legs or around the belly button.

How Is It Spread?

The bacteria that cause typhoid fever live in the intestines of humans and animals. It spreads primarily through contaminated food or water. People prepare and eat food without proper washing of hands or utensils. It is also possible to get it from another person who is infected. The bacteria spreads through the bloodstream and attacks the lining of the intestinal wall.

It can be spread from an infected person to someone else if they are within three feet of each other for a long period of time or through the air if both people are coughing at the same time.

How Is It Treated?

There are two kinds of medication that can be used to treat typhoid fever: those that kill the bacteria in your body and those that reduce the symptoms. The first line of treatment is usually a combination of antibiotics and fluids given intravenously to replace lost blood and water. If you have severe symptoms, you may need to be hospitalised.

If you are very young, old or have a pre-existing medical condition, you may suffer complications that require surgical care. You should see your doctor right away so he can determine if you need more advanced medical care.

You should drink plenty of fluids. If you do not feel like drinking, doctors sometimes prescribe intravenous fluids to prevent dehydration.

What Can You Do To Prevent It?

There are several ways to prevent getting or spreading this disease.

Food and water precautions are recommended in areas where the disease is common. This means avoiding any food that has been prepared by someone who is sick. It also means only drinking bottled water that has been boiled and filtering it first. Be careful with shellfish like shrimp and clams which can sometimes concentrate the bacteria even if they do not look spoiled.

Also, avoid any food that has come into contact with local sewage.

If you live in an area where the disease is common, it is a good idea to get vaccinated. While your doctor can vaccinate you against the disease, it takes a few weeks before its protective effects take hold.

The best way to prevent the spread of typhoid fever is to practice good handwashing. Use soap and water or an alcohol-based hand sanitiser and wash your hands after using the toilet, before preparing or eating food and before touching any open wound.

If you live in an area where the disease is common, it is a good idea to wear shoes that cover your feet and pants that fasten at the ankles. This will prevent you from coming into contact with the bacteria while walking through sewage contaminated areas.

Also, if you live in an area where the disease is common, its essential to seek medical care immediately if you develop a fever. If left untreated, the disease can be fatal.

If you are concerned that you may have contracted the disease, seek medical attention right away. The earlier it is detected and treated, the better your chances of making a full recovery.

There are vaccines available to protect against typhoid fever. You can ask your doctor about getting vaccinated.

What Is The Treatment For This Disease?

If you have contracted the disease and begin experiencing symptoms of fever, stomach pain, fatigue and loss of appetite, see your doctor immediately for treatment. You may need to be hospitalised if your symptoms are severe.

While the disease is usually not fatal if you seek treatment, there are some types of typhoid that can prove fatal in up to 20% of cases without treatment.

If you have been exposed to the bacteria and begin to experience symptoms of early typhoid fever within weeks or months after your exposure, you may be sent home from work or school while you undergo testing for the disease.

Blood and urine tests can confirm the presence of the disease. It is diagnosed by testing for the excretion of the bacteria in your urine.

If you are infected, you will be given antibiotics to kill the bacteria before it does lasting damage to your internal organs. You will have to take these until your physician feels your treatment is completed. In some cases, hospitalisation may be necessary for intensive treatment.

If you have been exposed to the bacteria and begin to experience symptoms of late typhoid fever after several months, a blood test can also confirm the disease.

Your physician may refer you to a specialist in infectious diseases if your case is severe.

What Not To Do

Typhoid fever is an illness that can affect anyone. No matter where you live or how healthy you are, you are at risk of infection.

If you have been exposed to the bacteria that causes typhoid fever or if you have recently returned from a country where the disease is common and begin to experience symptoms of fever, see your physician immediately.

While most people can recover completely with treatment, left untreated, the disease can be fatal in up to 20% of cases.

Don’t drink any alcohol while taking antibiotics.

Also, the drugs used to treat typhoid fever may not be safe for everyone. If you take any regular medication or have other health concerns, ask your physician before taking these drugs.

Typhoid fever is a serious illness that has been all but eradicated in many parts of the world thanks to proper sanitation and clean drinking water.

In our next article, we’ll look at another dangerous waterborne disease called Leptospirosis.

Where Did It Come From

Typhoid fever is a disease caused by a bacterium called Salmonella enterica. The disease is spread through food or water that has been contaminated by a human carrier of the illness.

The term “typhoid” comes from the severe bouts of fever experienced by those with the illness.

The disease is most common in places with poor sanitation where the water supply is contaminated with sewage.

Nevertheless, the disease can be found almost anywhere in the world and is most often contracted through ingestion of contaminated food or water.

The organism that causes the disease can survive outside of the body for weeks. It is resistant to acids and digestive juices so it can be contracted through ingestion of foods that have been undercooked or contaminated, even if they do not look or smell spoiled.

Foods most commonly associated with typhoid are those that have been cooked such as chicken, seafood or fruits, and then not kept at the right temperature. Other foods such as ice cream, salad ingredients and hams have all been known to be the cause of outbreaks due to contamination.

Washing your hands after using the bathroom and before eating or preparing food can help avoid contamination.

Typhoid fever is most commonly associated with developing countries where sanitary conditions are lacking, however anyone can get the disease anywhere in the world if they are exposed to contaminated food or water.

Typhoid can also be contracted from human carriers. If someone with the illness prepares food for you or serves you food in a restaurant, you can become infected with the disease without even knowing it.

It is estimated that in 2012, there were nearly 12 million incidents of typhoid fever worldwide with around 200 000 resulting deaths.

Typhoid fever is most common among children in the developing world with the highest rates seen in Sub-Saharan Africa and Southeast Asia.

There are an estimated 1 million cases of the disease reported per year in India alone.

While the disease is rare in the United States and other first world nations, it still occurs and begins when an infected person travels to a place where the disease is more common.

The first symptoms of typhoid fever typically occur between 7-14 days after infection. These symptoms include fever, malaise, headache, anorexia and abdominal complaints.

Some people may also experience pain in the region of the liver and spleen or a pink rash on the chest, stomach and abdomen.

The disease is most commonly spread through consumption of food or drink that has been contaminated by infected feces. It is not uncommon for sewage to leak into fresh water supplies which then contaminate the drinking water.

Typhoid fever is caused by the Salmonella typhimurium bacteria. It can also be spread through the air from an infected person coughing or sneezing.

If left untreated, the symptoms of typhoid fever can become serious and even life-threatening.

The most serious complication of typhoid is inflammation of the heart and/or the tissue around it. This condition is known as myocarditis and can cause death in some cases.

Typhoid fever can be treated by taking a combination of antibiotics such as ampicillin, chloramphenicol and trimethoprim/sulfamethoxazole for 7-10 days. Hospitalization may be required if the patient’s symptoms become severe.

“Symptomatic treatment” consists of treating the symptoms, like a high fever or diarrhea, that the patient is experiencing. For example, if a patient is experiencing persistent fever, they may receive medications to reduce the fever or antibiotics to treat an infection caused by salmonella typhi that has spread through the bloodstream.

Typhoid fever is most commonly spread by consuming food or drink that has been contaminated with infected feces. It may also be spread through the air from an infected person’s coughing or sneezing.

Typhoid fever is most common in places where there are problems with food sanitation. If human excrement leaks into water supplies, the bacteria can easily multiply and infect anyone who consumes the water. This is a problem in developing countries where sewers do not exist and toilets may not be connected to a sewage system.

The disease is also common among people living in close quarters with poor hygiene. This includes people who live in refugee camps or in prisons with poor sanitation.

While typhoid fever is still common in underdeveloped regions of the world, it can also occur in developed nations. This is most likely due to the consumption of contaminated food or water.

As with other types of salmonella infection, typhoid fever is diagnosed by testing a blood sample or a stool sample. Antibiotics such as ampicillin and ciprofloxacin are usually given to patients early in the course of their illness. The choice of drug, the dosage and the length of time they are administered depends on several factors, including the patient’s age and their weight.

Salmonella typhi is a bacteria that causes a type of food poisoning known as salmonellosis. There are several different types of salmonella that can cause illness in humans.

Salmonellosis is one of the most common types of food poisoning throughout the world. It is also known as salmonella food poisoning.

The bacteria are most commonly found in infected human and animal faeces. They can contaminate a wide range of foods, but are most commonly associated with eggs and meat.

Salmonellosis is a common cause of food poisoning around the world, particularly in the United States. It accounts for more than one million cases of food poisoning each year.

In Australia, about 1,000 people are hospitalized each year due to salmonellosis. The outbreak of the infection has been on the rise since 2010. This is particularly true among older people and children.

In the United States, salmonellosis makes up more than one million cases of food poisoning a year.

In the United Kingdom, there are around 2,000 cases of salmonellosis each year. Most of these cases are related to foods such as poultry, eggs and milk. The number of people with salmonella in their stool is higher among the elderly.

Most people infected with salmonella develop diarrhea, fever, nausea and vomiting. Most will recover after a few days. In some, the infection may spread through the bloodstream and cause death if not treated quickly.

Some people may have no symptoms at all but still be able to pass salmonella typhi to other people.

Infection with this type of salmonella can be very dangerous for certain groups of people. This includes those who suffer from weakened immune systems and those with certain chronic diseases.

This includes people who:

Salmonella typhi is primarily spread through the consumption of contaminated food or water. It can also be spread from an infected person to another person.

The symptoms of salmonellosis usually begin six to seventy-two hours after coming into contact with the bacteria. The infection can range from mild to severe.

Most people get better on their own within a week. In some cases, people can suffer from serious complications and die if it is not treated right away.

The infection can be diagnosed through laboratory testing of stool samples.

It is treated with antibiotics. Those at a higher risk of severe infections should seek immediate medical treatment.

Typhoid fever is rare in the United States today. It is most common in areas of the world where there is poor sanitation and inadequate water purification. It is also more common in places where people do not have easy access to medical care.

Most people infected with salmonella will recover after a few days. In some cases, the infection may spread through the bloodstream and cause death if not treated quickly.

In cases of poor personal hygiene, the bacteria can spread from the intestines to the urinary tract and sometimes to the blood. This can cause a more serious form of the disease known as salmonella septicemia.

Approximately 20% of women who suffer from salmonellosis while they are pregnant, will pass the infection on to their unborn child. In these rare cases, it can cause a life-threatening condition known as sepsis neonatorum. It can cause multiple organ failure and death in newborns.

Salmonella typhi has a wide range of symptoms. Most people will experience fever, diarrhea, headaches, stomach pains and vomiting. Some cases cause typhoid pneumonia, which causes a serious infection in the lungs. This can be deadly if left untreated.

Typhoid fever is caused by a strain of salmonella known as salmonella typhi. It spreads through food or water that has been contaminated with feces from an infected person. This can happen when poor hygiene is used when preparing food, when someone does not wash their hands after using the bathroom and then prepares meals without washing their hands, or when sewage contaminated with the feces of an infected person enters the water supply.

Typhoid fever is most commonly found in areas with major problems of poor sanitation. This includes many developing countries as well as some parts of Southern United States.

It is possible for a person to be infected and display no symptoms at all. It is also possible for some people to have a relatively mild illness. In these cases, the body is able to fight off the infection without medical treatment.

Children and adults who have a healthy immune system usually suffer from moderate symptoms. In these cases, it can easily be treated with antibiotics and the person will fully recover after a few weeks.

There are certain groups of people who have a higher risk of developing a serious case of the disease. These groups include the elderly, children under five years old, and anyone who has a compromised immune system due to disease or medication.

In some cases, people can suffer life-threatening complications. This is more common with children under the age of five and people with weakened immune systems. These cases may require hospitalization. Mortality rates are higher in these groups of people, but it is still rare and only accounts for less than 10% of cases.

Death usually occurs from complications that result from the disease in these serious cases, such as severe dehydration or damage to the vital organs. The elderly and young children are more likely to suffer serious complications and death.

Typhoid fever is rare in developed countries with good sanitation and medical care. It can be diagnosed by physical symptoms and by testing a stool sample.

The disease is diagnosed based on the symptoms, such as fever, headache, stomach pain, constipation or diarrhea, and rose-colored spots on the chest.

A blood test can confirm the diagnosis.

Typical treatment involves bed rest, adequate nutrition and fluids, along with antibiotics. In most cases of uncomplicated typhoid fever, the patient usually recovers within a few weeks.

Infants, and people with impaired immune systems, are more likely to develop complications.

Approximately 2-5% of those infected will suffer serious consequences. In these severe cases death may result if treatment is not implemented immediately.

A vaccine exists, but it is not always effective. Those at high risk of infection should seek medical advice to determine if they would benefit from being vaccinated.

Sources & references used in this article:

Typhlitis (neutropenic enterocolitis) after a single dose of vinorelbine by E Ferrazzí, S Toso, M Zanotti, G Giuliano – Cancer chemotherapy and …, 2001 – Springer

Rapid diagnosis of neutropenic enterocolitis (typhlitis) by ultrasonography by JE Gootenberg, SL Abbondanzo – Journal of Pediatric Hematology …, 1987 – journals.lww.com

Neutropenic enterocolitis (typhlitis) after pediatric bone marrow transplant by A Al Otaibi, C Barker, R Anderson, DL Sigalet – Journal of pediatric surgery, 2002 – Elsevier

Typhlitis (neutropenic enterocolitis) in patients with acute leukemia: a review by R Portugal, M Nucci – Expert review of hematology, 2017 – Taylor & Francis

Typhlitis: selective surgical management by CR Moir, CH Scudamore, WB Benny – The American journal of surgery, 1986 – Elsevier

Sonographic diagnosis of neutropenic typhlitis by SA Teefey, MA Montana… – American Journal of …, 1987 – Am Roentgen Ray Soc

Neutropenic enterocolitis. Clinical diagnosis and treatment by DS Wade, HR Nava, HO Douglass Jr – Cancer, 1992 – Wiley Online Library

Neutropenic enterocolitis (typhlitis) associated with infectious mononucleosis by A Sığırcı, A Akıncı, Ü Özgen, M Özen – Pediatric radiology, 2006 – Springer

Neutropenic enterocolitis in adults: case series and review of the literature by SC Cunningham, K Fakhry, BL Bass… – Digestive diseases and …, 2005 – Springer