Small-bowel biopsy was performed in 20 soldiers acutely ill with falciparum malaria. Histopathologic examination revealed minimum vascular congestion and edema of the lamina propria. Xylose absorption was impaired in eight of 10 patients tested, the abnormal results ranging between 1.25 and 2.80 g per 5 hours after a 25-g dose. In contrast, lactose-tolerance tests were normal (blood-glucose elevation greater than 20 mg per 100 ml) in 11 of 12 patients tested with an oral dose of 1.5 g per kg of body weight. The histopathologic findings and impairment of xylose absorption suggest that there may be decreased splanchnic blood flow in this disease similar to that observed in simian-malaria models.
Present address: Department of Cardiorespiratory Diseases, Walter Reed Army Institute of Research, Washington, D. C. 20012.
Present address: Armed Forces Institute of Pathology, Washington, D. C. 20012.