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April 5, 1976

Tuberculosis After Jejunoileal Bypass

Author Affiliations

Washington, Ga

JAMA. 1976;235(14):1425. doi:10.1001/jama.1976.03260400013009

To the Editor.—  In the article by Dr Pickleman (234:744, 1975), two cases of tuberculosis were reported. Dr Pickleman stated that to his knowledge this was the first report of such an occurrence.I previously reported two cases of tuberculous cervical adenitis following jejunoileostomy for obesity and noted that natural body resistance probably is low during the period of marked weight loss.1 One of the patients had arrested tuberculosis, and the other worked in a tuberculosis hospital. Both patients were successfully treated medically and have remained free of disease for six years.By combining Dr Pickleman's cases with mine, I note that three of the four had tuberculous cervical adenitis. This is unusual since it is rare for the original manifestations of tuberculosis to occur in the cervical glands.My cases occurred early in a series of 604 cases from November 1963 to December 1975. I have not had