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

BMJ Case Rep. 2012 Jun 5:2012:bcr0220125882. doi: 10.1136/bcr.02.2012.5882.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • DNA, Bacterial / analysis
  • Diagnosis, Differential
  • Duodenum / pathology*
  • Electromyography
  • Endoscopy, Gastrointestinal
  • Humans
  • Immunocompromised Host*
  • Male
  • Middle Aged
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / etiology*
  • Polymerase Chain Reaction
  • Tropheryma / genetics
  • Whipple Disease / diagnosis*
  • Whipple Disease / immunology
  • Whipple Disease / microbiology

Substances

  • DNA, Bacterial