51 year old male presented with neutropoenic sepsis after several months therapy with sulfasalazine for rheumatoid arthritis. He responded well to gentamicin and tazocin but became tachycardic and pyrexial again when these were stopped after 5 days. He had no positive cultures and no localising symptoms so was scanned as a pyrexia of unknown origin.
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Thickened descending colon and cecum with minor fat stranding.
These findings in a neutropaenic patient are in keeping with neutropaenic typhlitis.