Case history
Case history #1
A 47-year-old woman who has lived her whole life in Puerto Rico and recently moved to New York (US) presents with several months of chronic diarrhoea and foul-smelling, greasy stools. She has lost approximately 15 kg, has been complaining of fatigue, and has a sore, red tongue. Her laboratory tests reveal a macrocytic anaemia.
Case history #2
A 55-year-old male priest who has recently returned from a 3-month mission in Venezuela presents with chronic diarrhoea, abdominal cramps, anorexia, weight loss, fatigue, and swelling of the lower extremities. Examination reveals pitting oedema, thinning hair, and glossitis. Laboratory tests reveal a macrocytic anaemia, hypocalcaemia, hypomagnesaemia, and hypoalbuminaemia.
Other presentations
While typically an indolent process in natives from endemic areas, TS can present as an acute diarrhoeal illness that is rapidly followed by symptoms and findings consistent with malabsorption. This more acute presentation is commonly seen among expatriates and visitors to endemic areas.
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