Infectious Disease Compendium

Typhlitis

Diagnosis

A necrotizing disease where colonic organisms work together to invade the colon wall like a mixed synergistic necrotizing gangrene. Especially affects the cecum; presents with RLQ pain and increasing cecal size, sometimes with air in the lumen of the colon. When cecum is greater than 10 cm, time to panic (but with grace and style. You are, after all, a doctor).

Epidemiologic Risks

Neutropenia, AIDS.

Microbiology

Mixed/colonic flora, streptococci PLUS anaerobes PLUS coliforms.

Empiric Therapy

Surgery is the primary treatment, for antibiotics third generation cephalosporins PLUS metronidazole OR carbapenems OR quinolone PLUS metronidazole OR penicillin/beta-lactamase inhibitors ALL SELECTIONS +/- aminoglycosides if septic.

Pearls

Evidently is a problem in low land gorillas.

Rants

For some odd reason, surgeons do not like to operate on septic patients with no white cells and platelets. Go figure. Mortality rates are high no matter what you do.

ICD9 Codes (Soon to be supplanted by ICD10)

451.