Tropheryma whipplei bivalvular endocarditis and polyarthralgia: a case report

被引：4

作者：

Rivas Gruber J. ^{[1
]}

Sarro R. ^{[2
]}

Delaloye J. ^{[3
]}

Surmely J.-F. ^{[4
]}

Siniscalchi G. ^{[5
]}

Tozzi P. ^{[5
,8
]}

Jaques C. ^{[6
]}

Jaton K. ^{[7
]}

Delabays A. ^{[8
]}

Greub G. ^{[3
]}

Rutz T. ^{[8
]}

机构：

[1] Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 11, Lausanne

[2] Institute of Pathology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue de Bugnon 25, Lausanne

[3] Infectious Disease Service, Centre Hospitalier Universitaire Vaudois (CHUV), Rue de Bugnon 48, Lausanne

[4] Cabinet de Cardiologie, Rue des Charpentiers 9, Morges

[5] Service of Cardiac Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Rue de Bugnon 46, Lausanne

[6] Cabinet Medical, Avenue de Florimont 8, Morges

[7] Institute of Microbiology, University of Lausanne Switzerland, Rue de Bugnon 48, Lausanne

[8] Service of Cardiology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, Lausanne

来源：

Journal of Medical Case Reports | / 9卷 / 1期

关键词：

Arthralgia; Blood culture-negative endocarditis; Tropheryma whipplei;

D O I：

10.1186/s13256-015-0746-x

中图分类号：

学科分类号：

摘要：

Introduction: Tropheryma whipplei infection should be considered in patients with suspected infective endocarditis with negative blood cultures. The case (i) shows how previous symptoms can contribute to the diagnosis of this illness, and (ii) elucidates current recommended diagnostic and therapeutic approaches to Whipple's disease. Case presentation: A 71-year-old Swiss man with a past history of 2 years of diffuse arthralgia was admitted for a possible endocarditis with severe aortic and mitral regurgitation. Serial blood cultures were negative. Our patient underwent replacement of his aortic and mitral valve by biological prostheses. T. whipplei was documented by polymerase chain reactions on both removed valves and on stools, as well as by valve histology. A combination of hydroxychloroquine and doxycycline was initiated as lifetime treatment followed by the complete disappearance of his arthralgia. Conclusions: This case report underlines the importance of considering T. whipplei as a possible causal etiology of blood culture-negative endocarditis. Lifelong antibiotic treatment should be considered for this pathogen (i) due to the significant rate of relapses, and (ii) to the risk of reinfection with another strain since these patients likely have some genetic predisposition. © 2015 Rivas Gruber et al.

引用

共 19 条

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