tropical sprue

Etiology

• Klebsiella
• E. coli

Epidemiology

• travel to India, Thailand, Puerto Rico

Pathology

• duodenal villous atrophy & intraepithelial lymphocytosis

Clinical manifestations

• diarrhea 2-3 months after travelling to the topics
• weight loss
• megaloblastic anemia develops after 6 months due to folate deficiency & possible co-existing vitamin B12 deficiency
• glossitis may develop due to iron deficiency

Laboratory

• stool studies (rule out parasites)
• complete blood count (check for megaloblastic anemia)
• serum folate
• serum vitamin B12
• serum iron

Diagnostic procedures

• upper GI endoscopy with small intestine biopsy

Management

• tetracycline 250 mg QID or sulfonamide for 3-6 months
• folate
• vitamin B12

More general terms

• intestinal disease
• bacterial infection
• malabsorption