A 54-year-old man receiving induction chemotherapy for AML has fever, right lower-quadrant pain and neutrophils 0.1 × 10⁹/L. CT shows caecal wall

Question

A 54-year-old man receiving induction chemotherapy for AML has fever, right lower-quadrant pain and neutrophils 0.1 × 10⁹/L. CT shows caecal wall thickening, pericolic inflammatory change and no free air. What is the most appropriate initial management?

Accepted Answer

Give intravenous antibiotics and bowel rest with surgical assessment

Answer

Proceed to right hemicolectomy before a trial of medical treatment

Answer

Give empirical antifungal treatment pending repeat abdominal imaging

Answer

Give bowel rest and granulocyte-colony stimulating factor

Answer

Give intravenous antibiotics and perform colonoscopy within 24 hours

Febrile neutropenia after chemotherapy — SCE Acute Medicine MCQ

A 54-year-old man receiving induction chemotherapy for AML has fever, right lower-quadrant pain and neutrophils 0.1 × 10⁹/L. CT shows caecal wall thickening, pericolic inflammatory change and no free air. What is the most appropriate initial management?