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[Tropical or non-tropical sprue?].

S U C Sankatsing1, R J Leguit, F J W ten Kate

  • 1Academisch Medisch Centrum/Universiteit van Amsterdam, Meibergdreef, 1105 AZ Amsterdam. s.u.sankatsing@amc.uva.nl

Nederlands Tijdschrift Voor Geneeskunde
|November 3, 2005
PubMed
Summary

Tropical sprue, a cause of chronic diarrhoea after tropical travel, was diagnosed in a Dutch man presenting with fatigue and weight loss. Early diagnosis and treatment with antibiotics and vitamins led to successful recovery.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Diarrhoea is a common travel-related illness, with a significant minority of travelers developing chronic symptoms.
  • Distinguishing the cause of chronic diarrhoea after tropical travel is crucial for effective management.

Observation:

  • A 57-year-old man presented with weight loss and fatigue six months post-travel to West Papua, following severe diarrhoea.
  • Investigations revealed macrocytic anaemia, vitamin B12 deficiency, and partial villous atrophy on small intestine biopsy.
  • Coeliac disease was excluded due to negative antibody tests.

Findings:

  • Microscopic findings of partial villous atrophy, in the context of post-travel chronic diarrhoea and negative coeliac serology, were indicative of tropical sprue.

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  • The patient's symptoms resolved with treatment including vitamin B12, folic acid, and doxycycline.

    • Implications:

    • This case highlights the importance of considering tropical sprue in the differential diagnosis of chronic diarrhoea in patients with a history of tropical travel.
    • Prompt recognition and appropriate treatment can lead to successful patient outcomes.
    • Further research into the pathogenesis and optimal management of tropical sprue is warranted.