Whipple's disease

Whipple’s disease is a rare infection caused by the gram positive bacterium tropheryma whipplei . It may involve any organ system but most frequently affects the GI tract.

Whipple’s disease tends to present with:
  • Weight loss
  • Diarrhoea
  • Fever
  • Arthralgia
  • Abdominal pain
It also causes malabsoption so patients may present with clinical manifestations of this – for example, with anaemia due to B12 deficiency.

Up to a third of patients will have cardiac involvement, classically culture-negative endocarditis.

Possible clinical signs include
Whipple’s disease is commonest in Caucasian males (8:1)

Diagnosis is by
  • Histology – foamy macrophages filled with periodic acid-Schiff (PAS) positive particles
  • PCR
Treatment is 2 weeks IV ceftriaxone then 1 year of oral co-trimoxazole (=trimethoprim/sulfamethozaxole)


Small print gem: the original name for Whipple's disease was "intestinal lipodystrophy"


References
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Sarah Hudson

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas.

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)