Infectious Etiology of Diarrhea Occurring in Neutropenic Patients

Objective: Tha aim of this study is to investigate the incidence, clinical importance and etiologic agents of infectious diarrhea in patients with hematological malignancies undergoing neutropenia after chemotherapy. Methods: One hundred patients who developed neutropenia after chemotherapy were followed and monitored for abdominal symptoms (abdominal pain and diarrhea) and fever, prospectively. Stool samples were taken from 56 patients who developed diarrhea, and clinical data were collected by a structured survey. Statistical analysis was performed by SPSS 11.5 software. Results: Two (3.6%) samples were positive for Cryptosporidium oocysts, seven (12.5%) samples for Entamoeba histolytica trophozoites and antigen. Stool cultures were negative for enteric pathogens. Abdominal ultrasound was performed in 16 patients and thickening (> 4 mm) of the bowel wall was detected in 10 patients. However, no classic pathogen of neutropenic enterocolitis was detected in stool samples of these patients. Conclusions: Infectious agents are rarely reported as the cause of diarrhea in neutropenic patients. Thus, it is not necessary to perform complicated and expensive diagnostic procedures in order to identify the etiology of diarrhea in patients with neutropenia.