Tropical sprue: two cases in the Paris area

Tropical sprue (TS) is a postinfective tropical malabsorption that occurs in tropical countries. TS is associated with a persisting colonizotion of the small-intestine lumen by enterotoxinogenic bacteria that cause subsequent enterocyte damage affecting all or part of the small-intestine. We report two cases of TS that occurred in inhabitants of Paris area returned from endemic areas. The first observation con cerned a 76-year old woman admitted for anorexia, loss of 20 kg and anemia. The second observation concerned a 53-year old man referred for chronic diarrhea and loss of 40 kg within 4 years. In both cases, duodenal lesions consisted of subtotal and total villous atrophy with prominent infiltration of the damaged surface epithelium with lymphocytes and infiltrate of lymphocytes and plasma cells of the lamina propria. The two patients recovered under antibiotics, confirming the diagnosis of TS.