Case Report: Tropical sprue, diagnostic challenges of an old but unrecognized disease

نویسندگان

چکیده

Tropical sprue (TS) is a post-infective disease of the small bowel characterized by malabsorption syndrome affecting tropics inhabitants and visitors. Diagnosis TS remain challenging since it can be confused with common diarrheal diseases, especially in non-endemic areas. We report Tunisian case latent TS. A 58-year-old male history chronic watery diarrhea, was admitted to intensive care unit for confusion which related severe metabolic acidosis. Despite neurological improvement after hydro-electrolytic resuscitation acid-base disorders correction, patient continued have three five loose stools daily. nutritional assessment showed syndrome: iron, Vitamin B12 folate deficiencies; normochromic normocytic anemia hypoalbuminemia. Gastrointestinal endoscopy duodenal villous atrophy biopsy confirmed subtotal increased intraepithelial lymphocytosis thickened hyalonalized sub-epithelial basal lamina. Celiac evoked, however did not improve on gluten-free diet celiac serology negative. On re-interviewing, we discovered that had spent two months India years prior. Given travel history, clinico-biological histological data highly considered good response five-month antibiotic course combined supplementation supported this diagnosis. Clinico-biological, endoscopic findings were overlapping between other explaining diagnosis difficulties. should systematically discussed visitors presenting diarrhea. Improvement micronutrient vitamin deficiencies replacement prolonged supports TS.

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ژورنال

عنوان ژورنال: F1000Research

سال: 2022

ISSN: ['2046-1402']

DOI: https://doi.org/10.12688/f1000research.125305.1