Long-term Antibiotic Therapy in Tropical Sprue
Authors: Ricardo Guerra, Munsey S. Wheby, Theodore M. Bayless
Journal: Annals of Internal Medicine (1965)

Article1 October 1965Long-term Antibiotic Therapy in Tropical SprueRICARDO GUERRA, M.D., MUNSEY S. WHEBY, THEODORE M. BAYLESS, M.D.RICARDO GUERRA, M.D.Search for more papers by this author, MUNSEY S. WHEBYSearch for more papers by this author, THEODORE M. BAYLESS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-4-619 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe etiology and pathogenesis of tropical sprue are still unknown. The intestinal malabsorption that characterizes this disease is associated with alterations in the small intestinal mucosa. Folic acid deficiency is not believed to be the cause of these lesions, but folic acid (1) or vitamin B12 (2, 3) therapy usually results in rapid clinical improvement, hematologic remission, and some decreases in the jejunal abnormalities. However, in spite of this therapy, malabsorption continues in at least two thirds of the patients (4), and some remain incapacitated.An infectious cause of tropical sprue has been suspected, but no etiologic agent has been...References1. DARBYJONES WJE: Treatment of sprue with synthetic L. casei factor (folic acid, vitamin M). Proc. Soc. Exp. Biol. Med. 60: 259, 1945. CrossrefMedlineGoogle Scholar2. SPIESSUAREZ TDRM: Response of tropical sprue to vitamin B12. Blood 3: 1213, 1948. CrossrefMedlineGoogle Scholar3. SUAREZSPIESHERNANDEZ-MORALESPEREZ-SANTIAGO RMTDFE: Note on effectiveness of vitamin B12 in treatment of tropical sprue in relapse. Blood 4: 1124, 1949. CrossrefMedlineGoogle Scholar4. SHEEHYBAGGSPEREZ-SANTIAGOFLOCH TWBEMH: Prognosis of tropical sprue. A study of the effect of folic acid on the intestinal aspects of acute and chronic sprue. Ann. Intern. Med. 57: 892, 1962. LinkGoogle Scholar5. NADELGARDNER HFN: Bacteriological assay of small bowel secretion in tropical sprue. 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The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B12. J. Lab. Clin. Med. 42: 860, 1953. MedlineGoogle Scholar19. DACIEWHITE JVJC: Erythropoiesis with particular reference to its study by biopsy of human bone marrow: a review. J. Clin. Path. 2: 1, 1949. CrossrefMedlineGoogle Scholar20. CANCIORODRIGUEZ-MOLINAASENJO MRCF: Gluten and tropical sprue. Amer. J. Trop. Med. 10: 782, 1961. CrossrefGoogle Scholar21. BAYLESS TM: Tropical sprue: a comparison with celiac disease. Amer. J. Dig. Dis. 9: 779, 1964. Google Scholar22. DONALDSON RM: Normal bacterial populations of the intestine and their relation to intestinal function. New Eng. J. Med. 270: 1050, 1964. CrossrefMedlineGoogle Scholar23. GUERRAWHEBY RMS: Unpublished observations. Google Scholar24. ABRAMSBAUERSPRINZ GDHH: Influence of normal flora on mucosal morphology and cellular renewal in the ileum. A comparison of germ-free and conventional mice. Lab. Invest. 12: 355, 1963. MedlineGoogle Scholar25. EYRSENDE SOMER HP: The mode of action of antibiotics in stimulating growth of chicks. J. Exp. Med. 117, 127, 1963. CrossrefMedlineGoogle Scholar26. BAYLESSGUARDIOLAWHEBY TMAMS: Viral cultures in tropical sprue. In preparation. Google Scholar27. MANSON-BAHR P: The causation of tropical sprue. Lancet 2: 389, 1953. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: San Juan, Puerto RicoFrom the U. S. Army Tropical Research Medical Laboratory, and the Department of Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.This paper was presented in part at the Forty-fifth Annual Session of the American College of Physicians, Atlantic City, N. J., April 8, 1964.Requests for reprints should be addressed to Munsey S. Wheby, M.D., Department of Medicine, Rutgers Medical School, New Brunswick, N. J. 08903. 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