Impairment ofd-xylose absorption in Zambian patients with systemic bacterial infections

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Abstract
Urinary excretion of d-xylose during a 5-hr period after 25 g of the sugar was given orally has been estimated in 70 Zambian African men. Seventeen had pulmonary tuberculosis and sixteen had an acute bacterial infection. Six healthy Englishmen were also studied. The mean excretion of xylose in the tuberculosis (P < 0.001) and acute infection (P < 0.05) groups was significantly lower than that in Zambian patients without bacterial infections. Both groups with infections had a significantly lower excretion than the Englishmen. In the probable absence of renal disease, it seems likely that the results represent an impairment of xylose absorption in the presence of systemic bacterial infections. The reason for this impairment is not clear but it does not seem to be associated with altered jejunal morphology, which was studied in 17 of the patients. If dietary constituents are also poorly absorbed in the presence of systemic infection, this observation may explain part of the weight loss in patients with chronic bacterial infections. As patients with kwashiorkor often have evidence of a bacterial infection, it seems probable that systemic infections are an etiological factor in malnutrition.