How much do you know about tropical sprue?

Study Notes

Tropical sprue affects people in tropical countries between the Tropics of Cancer and Capricorn, and sporadic cases are seen among immigrants and returning tourists from these areas.
The cause of tropical sprue is unknown, but it is likely caused by an infectious agent or alterations in intestinal bacteria due to environmental factors.
Symptoms include diarrhea, steatorrhea, weight loss, nausea, anorexia, and anemia.
Anemia is often megaloblastic and reflects deficiencies in vitamin B12 or folate, or both.
Diagnosis relies on excluding other diseases with similar symptoms, such as celiac sprue and protozoal infections.
Treatment includes tetracycline and high-dose folic acid, as well as correcting nutritional deficiencies.
The optimal duration of treatment is unclear, but 1 month appears to be sufficient for most travelers and expatriates, while 6 months to 1 year is recommended for chronically ill residents in the tropics.
The response to treatment is usually prompt, and the prognosis with proper treatment is excellent.
Relapses can occur months to years after treatment.
Response to treatment may be more predictable among those with tropical sprue acquired in the Caribbean than in Asia, but comparative studies are not available.