R. BRADLEY SACK, M.D., SC.D.
To the editor: I read with interest the article by Klipstein and colleagues, "Enterotoxigenic Intestinal Bacteria in Tropical Sprue" (Ann Intern Med 79:632-641, 1973).
Having struggled extensively with the perplexities of the rabbit intestinal-loop model in studying enterotoxins of Vibrio cholerae and Escherichia coli (1, 2), I question whether the data presented by the authors necessarily indicate the presence of enterotoxigenic bacteria in the small intestines of patients with tropical sprue. The amount of crude culture filtrates used to challenge 10-cm intestinal loops was given as 750 mg. This dose is from one thousand to ten thousand times greater than
SACK RB. Entertoxigenicity in Sprue?. Ann Intern Med. ;80:426. doi: 10.7326/0003-4819-80-3-426_1
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Published: Ann Intern Med. 1974;80(3):426.
Celiac Disease and Malabsorption, Gastroenterology/Hepatology.
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