Whipple’s Disease: Case Report
DOI:
https://doi.org/10.60591/crspmi.424Keywords:
Whipple Disease/diagnosisAbstract
Whipple’s disease (WD) is a rare systemic bacterial infection caused by Tropheryma whipplei, with an estimated incidence of one to three cases per million inhabitants. It commonly presents with persistent arthralgia, chronic diarrhea, abdominal pain, and weight loss, potentially affecting other systems, such as the neurological and cardiovascular systems. We report the case of a 41-year-old female patient with abdominal and pelvic pain, intermittent diarrhea, arthralgia, myalgia, night sweats, and unintentional weight loss of 5 kg over a short period. Initially, mesenteric lymphadenopathy raised suspicion of sarcoidosis. However, a duodenal biopsy revealed periodic acid-schiff (PAS)-positive macrophages, confirming the diagnosis of WD. The patient was treated with intravenous ceftriaxone, followed by oral trimethoprim-sulfamethoxazole (TMP-SMX) for one year. WD should be considered in the differential diagnosis of malabsorption syndromes and multisystemic diseases, given its progressive course and the potential benefit of early treatment.
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1. Ioannou P, Kourtidis M, Mytilinis DO, Psyllaki A, Baliou S, Kofteridis D. Whipple's disease-associated infective endocarditis: a systematic review. Infect Dis. 2023;55:447-57. doi: 10.1080/23744235.2023.2214610.
2. Viegas AF, Lopes AM, Venade G, Rodrigues P, Tavares J. Why is Whipple's disease still a challenging diagnosis? a case report and brief review of literature. Cureus. 2023;15:e34029. doi: 10.7759/cureus.34029.
3. Marth T, Moos V, Müller C, Biagi F, Schneider T. Tropheryma whipplei infection and Whipple's disease. Lancet Infect Dis. 2016;16:e13-22. doi: 10.1016/S1473-3099(15)00537-X.
4. Günther U, Moos V, Offenmüller G, Oelkers G, Heise W, Moter A, Loddenkemper C, Schneider T. Gastrointestinal diagnosis of classical Whipple disease: clinical, endoscopic, and histopathologic features in 191 patients. Medicine. 2015;94:e714. doi: 10.1097/MD.0000000000000714.
5. Manini A, Querzola G, Lovati C, Pantoni L. Rapidly progressive dementia and intractable diarrhea: a teaching case report and a systematic review of cognitive impairment in Whipple's disease. Neurol Sci. 2022;43:907-26. doi: 10.1007/s10072-021-05844-5.
6. Fenollar F, Puéchal X, Raoult D. Whipple's disease. N Engl J Med. 2007; 356:55. doi: 10.1056/NEJMra062477.
7. Crews NR, Cawcutt KA, Pritt BS, Patel R, Virk A. Diagnostic Approach for Classic Compared With Localized Whipple Disease. Open Forum Infect Dis. 2018 ;5:ofy136. doi: 10.1093/ofid/ofy136.
8. Durand DV, Lecomte C, Cathébras P, Rousset H, Godeau P. Whipple disease. Clinical review of 52 cases. The SNFMI Research Group on Whipple Disease. Société Nationale Française de Médecine Interne. Medicine.1997;76:170-84. doi: 10.1097/00005792-199705000-00003.
9. De Francesco V, Corsi F, Pennella A, Bellesia A, Fiorini G, Vaira D, et al. Whipple's disease: case report and review of the literature. J Gastrointestin Liver Dis. 2018;27:331-6. doi: 10.15403/jgld.2014.1121.273.fra.
10. Marth T. Systematic review: Whipple's disease (Tropheryma whipplei infection) and its unmasking by tumour necrosis factor inhibitors. Aliment Pharmacol Ther. 2015;41:709-24. doi: 10.1111/apt.13140.
11. Ectors N, Geboes K, De Vos R, Heidbuchel H, Rutgeerts P, Desmet V, et al. Whipple's disease: a histological, immunocytochemical and electronmicroscopic study of the immune response in the small intestinal mucosa.
Histopathology. 1992;21:1-12. doi: 10.1111/j.1365-2559.1992.tb00337.x.
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Copyright (c) 2025 Greicy Demeneghi Martini, Gustavo Torquato Ribeiro, Leonardo Priesnitz Friedrich , Giovanna Messagi Caldeira , Hugo Leonardi Baldisserotto

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