Neutropenic enterocolitis refers to a severe, potentially fatal necrosis of the colon or small bowel that occurs in an immunocompromised patient. The etiology is not clearly described but likely is triggered by impaired host immune response and underlying mucosal injury. Inflammation and necrosis occur most frequently in the cecum but can involve any area of the small bowel or colon.

Patients with leukemia undergoing cytotoxic chemotherapy are at highest risk for neutropenic enterocolitis. This was initially appreciated in pediatric patients but is seen in adults as well. Any patient with chemotherapy-induced neutropenia is at an increased risk for neutropenic enterocolitis.

Neutropenic enterocolitis commonly presents with right lower quadrant abdominal pain, diarrhea, and fever with underlying neutropenia or immune compromise. Patients can develop severe sepsis with end-organ damage and bowel perforation with progressive neutropenic enterocolitis. Early recognition and treatment of sepsis with intravenous antibiotics and volume resuscitation, along with surgical intervention if necessary, are the hallmarks of treatment that can improve mortality. If untreated, neutropenic enterocolitis can be fatal.