A Case Report of Whipple's Disease: A Challenging Diagnosis

被引：1

作者：

Nunes, Filipa ^{[1
]}

Bastos, Martim Trovao ^{[1
]}

Fernandes, Maria Joao ^{[1
]}

Oliveira, Jessica ^{[1
]}

Costa, Mariana ^{[1
]}

机构：

[1] Hosp Prof Doutor Fernando Fonseca, Internal Med Dept, Lisbon, Portugal

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2023年 / 15卷 / 06期

关键词：

weight loss; whipple disease; tropheryma whipplei; bilateral pleural effusion; constitutional syndrome;

D O I：

10.7759/cureus.41021

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Whipple's disease is caused by a ubiquitous Gram-positive bacillus, Tropheryma whipplei. The disease is extremely rare, with only 1,000 cases reported worldwide. Classic Whipple's disease is characterized by a multisystemic involvement with joint (arthralgias) and gastrointestinal (abdominal pain, diarrhea, and weight loss) symptoms. We present a case of a 48-year-old male who had a constitutional syndrome associated with an exuberant bilateral pleural effusion. The small bowel biopsy identified a rod-shaped bacterial cologne in the macrophage cytoplasm, positive for periodic acid-Schiff (PAS) staining, and the polymerase chain reaction (PCR) exam identified the DNA of Tropheryma whipplei. The patient was medicated with two weeks of endovenous antibiotherapy with ceftriaxone 2 g per day, followed by one year of oral trimethoprim 160 mg and sulfamethoxazole 800 mg twice daily. He presented good evolution with total resolution of symptoms.

引用

页数：5

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