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Brucellosis was a relevant differential owing to regional endemicity, but the absence of livestock exposure, unpasteurized dairy consumption, or fever made it unlikely

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Sources Weight loss surgery (2025) NHS [accessed 27 October 2025] Tirzepatide for managing overweight and obesity (2024) NICE [accessed 27 October 2025] Bariatric Surgery Frequently Asked Questions (2025) NHS North Bristol [accessed 27 October 2025] Weight Loss Surgery Prices (2025) Ramsay Health [accessed 27 October 2025] Having an operation (surgery) (2024) NHS [accessed 27 October 2025] Dumping syndrome (2025) Mayo Clinic [accessed 27 October 2025]

Wolffenbuttel BHR, Muller Kobold AC, SobczyskaMalefora A, Harrington DJ

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