Data on the risk factors for
typhlitis in children with
cancer are limited. The aim of the study was to define the epidemiologic and clinical features of
typhlitis and to elucidate predisposing factors for its development. The medical records of pediatric patients with
cancer who were diagnosed with
typhlitis from 1995 to 2005 were reviewed for clinical, laboratory, and imaging findings. The results were compared with a group of patients with
cancer but without
typhlitis who were hospitalized during the same period. Of the 843
cancer patients, 42 (5%) had episodes of
typhlitis; 32 of them (76%) were being treated for
hematologic malignancies. The incidence was highest in patients with
Burkitt's lymphoma (15%) and
acute myeloblastic leukemia (12%). Work-up included abdominal x-ray in all patients; abdominal ultrasonography and computed tomography were performed in 23% and 11% of patients, respectively. No cases were missed by plain x-ray when compared with computed tomography and ultrasonography. The
typhlitis was treated without surgery and survival was 100%. On multivariate analysis,
mucositis [odds ratio (OR) = 30.7],
stem cell transplantation (OR = 58.9), and receipt of
chemotherapy in the previous 2 weeks (OR = 12.9) were significantly associated with the occurrence of
typhlitis. We conclude that most children with
typhlitis may be treated without surgery in most cases with favorable outcome. A high index of suspicion may be warranted in patients after
stem cell transplantation or
chemotherapy and patients with
mucositis.