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Dermatological manifestations of serious gastrointestinal disorders
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Whipple disease, caused by bacterium Tropheryma whipplei, is a rare systemic disorder primarily involving the small intestine. The most common cutaneous sign is diffuse hyperpigmentation in photo-exposed areas. Erythroderma, purpura, vasculitis, panniculitis, and urticaria can be other cutaneous manifestations although they are very rare. Affected patients may have abdominal pain, diarrhea, and malabsorption in the advanced stage. Neurological, ophthalmic, cardiac, or pleural involvement has also been seen in advanced disease [22]. Diagnosis can further be confirmed by demonstration of periodic acid-Schiff (PAS) positive particles in duodenal endoscopy biopsy, by immunohistochemistry, or polymerase chain reaction [23]. An appropriate antibiotic such as penicillin, tetracycline, or cotrimoxazole for 1–2 years can alleviate the disease process.
Normal and Abnormal Intestinal Absorption by Humans
Published in Shayne C. Gad, Toxicology of the Gastrointestinal Tract, 2018
David W. Hobson, Valerie L. Hobson Balldin
Whipple’s disease is a rare infectious disease caused by bacteria, Tropheryma whipplei. It can affect any system of the body but occurs most often in the small intestine and interferes with the body’s ability to absorb certain nutrients. Whipple’s disease causes weight loss, incomplete breakdown of carbohydrates or fats, and malfunctions of the immune system. Diagnosis is based on symptoms and the results of a biopsy of tissue from the small intestine or other organs that are affected. When recognized and treated with antibiotics, Whipple’s disease can usually be cured. Untreated, the disease may be fatal. Full recovery of the small intestine may take years and relapses are not uncommon [63].
Rifampicin (Rifampin)
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
C. Alan, C. Street, Tony M. Korman
Tropheryma whipplei is the cause of Whipple disease. Using a cell culture system and real-time PCR to assess organism growth in the presence of antibiotic, Boulos et al. (2004) demonstrated that this organism is susceptible to a number of different antibiotics, including rifampicin.
Whipple’s disease-associated infective endocarditis: a systematic review
Published in Infectious Diseases, 2023
Petros Ioannou, Marios Kourtidis, Dimitrios-Orestis Mytilinis, Anna Psyllaki, Stella Baliou, Diamantis Kofteridis
The basic pathophysiologic characteristic of Whipple’s disease is considered to be associated with the infiltration of the tissues by the pathogen and the associated inflammatory response. The response of the immune system of the infected host is to activate phagocytes in the infected tissues, leading to phagocytosis of the pathogens. Indeed, even conventional light microscopy can confirm the tissue infiltration by macrophages in infected patients, and these macrophages are also PAS-positive. The role of the immune system may be crucial in the pathogenesis of Whipple’s disease. This is supported by the fact that T. whipplei DNA can be found in asymptomatic individuals [102]. For example, in one study, the DNA of this microorganism was identified in up to 40% of healthy patients [103].
Current knowledge for the microbiological diagnosis of Tropheryma whipplei infection
Published in Expert Opinion on Orphan Drugs, 2020
Sophie Edouard, Léa Luciani, Jean-Christophe Lagier, Didier Raoult
T. whipplei was first thought to be an uncommon bacterium that caused a rare disease [53]. Since the strain has been cultured, the genome has been sequenced and diagnostic tools have improved and come into more widespread use, leading to increase of knowledge about the bacterium, its epidemiology and pathogenicity [12]. Classic Whipple’s disease and localized infections remain rare and fatal clinical entities without antibiotic treatment, whereas T. whipplei is a more common bacterium and associated with a wider diversity of clinical presentation than initially described, including frequent asymptomatic carriage and acute infections (gastro-enteritis, pneumonia, and bacteremia) [15]. Immunological and genetic predispositions to the disease are suggested due to the high prevalence of carriage and acute infection compared to the rarity of Whipple’s disease in target populations, notably in Africa and Asia [20,23]. Intrafamilial circulation, lifetime susceptibility, and the absence of a correlation between clinical severity and genotype support this hypothesis, which requires further investigation. In addition, difficulty in culturing bacteria and protean clinical entities mean that the pathogenicity of T. whipplei is far from being fully elucidated.
Imaging of infectious and inflammatory cystic lesions of the brain, a narrative review
Published in Expert Review of Neurotherapeutics, 2023
Anna Cervantes-Arslanian, Hector H Garcia, Otto Rapalino
Whipple’s disease is a rare multi-system infectious disease caused by the Gram-positive bacillus Tropheryma whippleii. Clinical symptoms classically include chronic diarrhea, low grade fever, and migratory polyarthralgia but neurologic symptoms can occur in up to 40% [16]. Neurologic manifestations are protean but oculomasticatory myorhythmia and oculo-facial-skeletal myorhythmia are considered pathognomic for CNS Whipple’s but occur in only a minority. Neuroimaging findings are often nonspecific or may be normal. Focal lesions have been described, usually solid masses but can also be cystic. MR shows T1 hypointense, T2 hyperintense circumscribed mass with contrast enhancement and marked surrounding edema [17].