Phlegmonous Gastritis as the First Presentation of Acute Leukemia: A Case Report.

Phlegmonous gastritis (PG) is a serious and severe suppurative gastric infection. Diagnosis is delayed due to its uncommon and non-specific clinical presentation. This led to a high mortality rate; however, early treatment with broad-spectrum antibiotics can reduce mortality and complications. We describe a case of a 56-year-old patient who presented with severe abdominal pain, vomiting, and pyrexia. Blood tests showed pancytopenia, and she was newly diagnosed with acute myeloid leukemia (AML) on this admission. Her computed tomography (CT) and endoscopic evaluation showed thickening and swelling of the gastric wall consistent with PG. She responded well to conservative treatment, and she is on regular follow-up as an outpatient. This case highlights the importance of suspecting PG in severe abdominal pain and neutropenia. This will reduce the complications, mortality, and requirement for surgical intervention.