Long-Term Follow-Up of Antibiotic-Treated Tropical Sprue

Clinical status and intestinal structure and function were evaluated in 17 patients with tropical sprue who, 5 years or more in the past, had been treated with antibiotic agents for at least 6 months. Three patients were experiencing gastrointestinal symptoms, and six had lost weight. Two patients were deficient in folate and two in vitamin B-12. Three patients had steatorrhea: the absorption of xylose was subnormal in 8; that of folic acid, subnormal in 2; and that of vitamin B-12, subnormal in 13. Jejunal morphology was abnormal in eight patients. Intestinal abnormalities, in most instances, represented a reversal to abnormal after cessation of the antibiotic therapy; however, in a few cases of chronic sprue they were persistent changes. Apparently, not only is antibiotic therapy not totally curative in all cases of tropical sprue, but, in persons living in the tropics, there is also a high rate of either relapse or recurrence of intestinal abnormalities after cessation of treatment.