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May 1980

Unusual Fungal Infections Following Jejunoileal Bypass Surgery

Author Affiliations

From the Vanderbilt University Medical Center (Drs Tustin and Kaiser); the Division of Infectious Diseases (Drs Tustin and Kaiser) and Department of Surgery (Dr Herrington), St Thomas Hospital; and the Division of Infectious Diseases, Nashville Veterans Administration Hospital (Dr Bradsher), Nashville, Tenn.

Arch Intern Med. 1980;140(5):643-645. doi:10.1001/archinte.1980.00330170059025

• Deep-seated fungal infections with unusual clinical courses developed in three previously healthy patients following jejunoileal bypass surgery. Pulmonary blastomycosis disseminated and then relapsed despite repeated courses of amphotericin B in a 40-year-old man; chronic progressive pulmonary histoplasmosis developed in a 38-year-old nonsmoking man; and histoplasmosis of mediastinal nodes became symptomatic in a 32-year-old man. Cell-mediated immunity was evaluated in two patients; no defects were found. However, male patients were found to be at a significantly higher risk of infection than female patients (3/32 vs 0/101; P <.02). A significantly higher percentage of prebypass weight was lost by the infected men than the uninfected men (P <.05). Accelerated weight loss clearly preceded the onset of the infection in two of the patients. Jejunoileal bypass surgery should be regarded as a risk factor for serious fungal infection, especially in men with accelerated weight loss.

(Arch Intern Med 140:643-645, 1980)