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Tuberculosis after jejunoileal bypass for obesity
Annals of Internal Medicine
|November 1, 1977
Summary
Jejunoileal bypass surgery for obesity can lead to a sixtyfold increase in tuberculosis risk. Suspect tuberculosis in bypass patients with unexplained fever, weight loss, and swollen lymph nodes.
Area of Science:
- Bariatric Surgery Outcomes
- Infectious Disease Epidemiology
Background:
- Jejunoileal bypass (JIB) was a surgical procedure for morbid obesity.
- Long-term complications of JIB are not fully understood.
Observation:
- Four of 100 patients undergoing JIB developed a tuberculosis-like illness within one year.
- This represents a 60-fold higher incidence than in the general population.
Findings:
- Patients presented with accelerated weight loss, lymphadenopathy, and fever.
- Tuberculosis should be suspected in JIB patients with these symptoms.
Implications:
- Aggressive diagnostic evaluation for tuberculosis is crucial in post-JIB patients.
- Standard treatment with isoniazid and ethambutol may be effective, but therapeutic drug monitoring is advised.
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