Work

The Nutritional Management of Typhlitis in a Limited-Resource Setting: A Case Series with Recommendations for Implementation

Year: 2026

Type: article

Abstract: Introduction: Typhlitis is a life-threatening complication of chemotherapy. The recommended nutritional management of typhlitis involves bowel rest and initiating parenteral nutrition (PN). However, in limited-resource settings, PN is not readily available, leaving patients who develop typhlitis without nutrition for prolonged periods. Strategies for the nutritional management of typhlitis in settings without access to advanced nutritional therapies are urgently needed. Case Presentations: Three patients with acute leukemia presented to Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia, for treatment, where PN is unavailable. All three patients presented with acute malnutrition at diagnosis and developed typhlitis during chemotherapy. In each case, oral feeding was reintroduced prior to complete resolution of typhlitis, guided by improved bowel thickness, recovery from neutropenia, and resolution of gastrointestinal symptoms. Conclusion: Gradual reintroduction of oral feeding based on clinical indicators was successfully implemented across this case series, minimizing prolonged periods without oral intake and preventing further decline in nutritional status in the absence of PN. Drawing from this experience and the existing literature, we propose an algorithm to guide nutritional management during typhlitis in similar clinical contexts.

Source: Case Reports in Oncology

DOI: 10.1159/000551722

Authors: Daniel Hailu, Tsigereda Yitbarek, Michelle Walters, Elena J. Ladas

Institutions: Addis Ababa University, Columbia University Irving Medical Center, Columbia University

Language: English

Topic: Clinical Nutrition and Gastroenterology

Subfield: Nutrition and Dietetics

Field: Nursing

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,170