The interaction of malnutrition and infection is the leading cause of morbidity and mortality in the so-called developing nations and among the poorer communities of the affluent nations.1,2 Infections are more abundant, of longer duration, and more severe in malnourished as compared to well-nourished populations.2,3 The most dramatic expressions of this interaction is the precipitation of kwashiorkor by measles and the exceedingly high case fatality of measles in malnourished children.4 Less dramatic is the chronic and wide-spread coexistence of moderate malnutrition and commonplace but abundant respiratory, intestinal, and skin infections.1,5
The problem of synergism of malnutrition and infection is only recently being appreciated in this country, not only in disadvantaged communities but in the context of the hospitalized patient, debilitated nutritionally from a variety of chronic diseases, particularly malignancy, gastrointestinal disorder, and, sometimes, drastic but life-saving treatments. Protein-calorie malnutrition (PCM) in all degrees is now being