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Small bowel (small intestine)


Tropical sprue

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 14 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.


● Also called post-infectious sprue
● Affects people living in or visiting the tropics, particularly Caribbean (not Jamaica), Africa, India, SE Asia, Central/South America (Case Rep Gastroenterol 2010;4:168)
● Has endemic and epidemic features
● May be due to E. coli or Haemophilus
Symptoms: malabsorption within weeks of acute diarrheal enteric infection


● Broad-spectrum antibiotics (tetracycline), folic acid, vitamin B12
● No increased risk of intestinal lymphoma

Micro description

● Variable villous atrophy (none, partial, total)
● Injury to entire small bowel (not proximal as in celiac sprue), inflammatory infiltrate, crypt hyperplasia

Micro images

Various images

40 yr old man with chronic diarrhea who improved after antibiotics; marked villous atrophy in duodenal biopsy but no increase in intraepithelial lymphocytes (courtesy of Dr. Hanni Gulwani)

Additional references

Gastrointest Endosc 2007;66:377, Dig Dis Sci 2011;56:161

End of Small bowel (small intestine) > Malabsorption > Tropical sprue

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