BMJ Case Reports 2012; doi:10.1136/bcr.02.2012.5882
  • Rare disease

Whipple's disease presenting with neurological symptoms in an immunosuppressed patient

  1. Cees Verburgh2
  1. lDepartment of Neurology, Kennemer Gasthuis, Haarlem, Netherlands
  2. 2Department of Internal Medicine, Kennemer Gasthuis, Haarlem, Netherlands
  1. Correspondence to Professor Martijn Weisfelt, weisfelt{at}


We report an unusual case of Whipple's disease, which remained undiagnosed for several years in a patient being treated with immunosuppressive therapy for many years. The patient presented with a purpuric rash, neurological symptoms, lymphadenopathy and gastrointestinal symptoms. The diagnosis was made by endoscopic biopsy of the duodenum with periodic acid Schiff staining, as well as PCR testing on blood and cerebrospinal fluid. The patient was successfully treated with intravenous ceftriaxone, followed by oral co-trimoxazole for 1 year.


  • Competing interests None.

  • Patient consent Obtained.

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