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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.
Human galectin-1 and galectin-3 promote Tropheryma whipplei infection
Published in Gut Microbes, 2021
Diyoly Ayona, Sandra Madariaga Zarza, Ludovic Landemarre, Benoît Roubinet, Philippe Decloquement, Didier Raoult, Pierre-Edouard Fournier, Benoit Desnues
Tropheryma whipplei is the causative agent of Whipple’s disease (WD),1 a rare systemic illness that mainly affects middle-aged Caucasian men.2 Classically, the disease occurs with severe infection of the small intestinal lining3 which is characterized by the infiltration in the lamina propria by heavily infected large foamy macrophages strongly stained by the Periodic acid Schiff (PAS) reagent.4 Later the infection may spread into different organs, mostly eyes, central nervous system and heart.5,6 WD can be fatal without early and proper treatment.7 The typical characteristics of the disease are weight loss, diarrhea, arthralgia, fever and hyper pigmentation of the skin2 and fat accumulation in the small intestine and mesenteric lymph nodes.8T. whipplei infections can also manifest as chronic localized infections, such as endocarditis and encephalitis.9,10 Beside chronic infections, the bacteria can also cause acute infections mainly, gastroenteritis, pneumonia, and bacteremia.5 Most individuals develop a protective immune response against T. whipplei infection11,12 and asymptomatic carriage of T. whipplei is common.13 The development of the disease in a minor fraction of the population probably arise from a subtle genetic predisposition or an immune defect.5 Indeed, in patients, impaired bactericidal activity toward T. whipplei is associated with alternative activation of phagocytic cells and an anti-inflammatory response, suggesting a defect in macrophage functions during WD.11,12,14
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
Our objectives in this study are to review and summarize the laboratory diagnosis of Whipple’s disease and to propose an update of our diagnostic strategy. We searched in Medline and Google scholar for references using the keywords ‘Tropheryma whipplei’ OR ‘Whipple’s disease’ AND ‘diagnosis’ without any restrictions to date or language. This search yielded 934 references. We removed duplicates and assessed the remaining references for eligibility. Ultimately, 78 relevant references were selected and included in our analysis.
Unique Features of Posterior Ocular Involvement of Whipple’s Disease in a Patient with No Gastrointestinal Symptoms
Published in Ocular Immunology and Inflammation, 2022
Francesca Bosello, Giuseppe Casalino, Enrico Neri, Alessandro Alfano, Adriana Bonora, Giorgio Marchini
Whipple’s disease (WD) is a rare multiorgan bacterial infection caused by Tropheryma Whipplei.1 The disease, affecting mostly men in their fifth decade, is mainly characterized by gastrointestinal (GI) disorders, but can involve any part of the body such as joints, lymph nodes, eyes, and central nervous system (CNS).2 If left untreated, WD may be life-threatening due to CNS involvement. Ocular manifestations are rare in patients with WD and usually occur late in the disease course.1,2