Chronic salmonella septicemia and malabsorption of vitamin A

Vitamin A absorbtion was studied in two groups of subjects using a vitamin A tolerance test. The first group consisted of 15 patients with chronic salmonella bacteremia associated with Schistosoma manosoni infection and refractory anemia. The second group consisted of 11 patients with active S. mansoni infection associated with anemia but without concurrent salmonellosis. None of the patients had clinical signs of vitamin A deficiency. Ten healthy Egyptians of the same age group with no evidence of any infection served as controls for this absorption test. On admission the mean values of fasting vitamin A and carotene levels in the first group were lower than those in the 2nd group and both levels were significantly lower (P<0.001) than the control group mean level. Similarly, the mean peak vitamin A rise after the test dose in the 1st group was significantly lower (P<0.01) than the mean peak rise in the 2nd group and both were significantly lower (P<0.001) than the control group mean level. After receiving the appropriate therapy, however, the mean fasting vitamin A and carotene levels showed significant increase in both groups (P<0.001). There was also a significant improvement (P<0.001) in vitamin A absorption of the 1st group and insignificant increase in the 2nd group but both groups remained significantly lower (P<0.001) than the control group mean absorption level. The results of this study suggest that chronic salmonellosis may cause gross impairment in vitamin A absorption and may contribute significantly to the wide prevalence of vitamin A deficiency in a given population with borderline dietary intake.