Tuberculosis After Jejunoileal Bypass for Obesity

Abstract
Patients (100) who underwent jejunoileal bypass for obesity were followed for a mean period of 2 1/2 yr. Patients (4) developed a clinical illness that resembled a systemic form of tuberculosis during the 1st postoperative year. This incidence exceeds that found in the general population by 60-fold. Any patient with jejunoileal bypass who develops an illness with accelerated weight loss, enlarged lymph nodes and unexplained fever with chills should be suspected of having tuberculosis. Aggressive diagnostic measures are required. Treatment with isoniazid and ethambutol at usual doses can be successful, but blood levels should be measured to confirm adequacy until additional information becomes available.

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