Misdiagnosing Whipple's disease in the young

BMJ Case Rep. 2017 Mar 21:2017:bcr2016218866. doi: 10.1136/bcr-2016-218866.

Abstract

Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Ceftriaxone / therapeutic use
  • Diagnosis, Differential
  • Diagnostic Errors*
  • Duodenum / pathology
  • Humans
  • Lymph Nodes / pathology*
  • Male
  • Toxoplasmosis / diagnosis
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Whipple Disease / diagnosis*
  • Whipple Disease / drug therapy
  • Whipple Disease / microbiology
  • Whipple Disease / pathology*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Trimethoprim, Sulfamethoxazole Drug Combination