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Whipple disease associated with giardiasis.

Florence Fenollar1, Hubert Lepidi, René Gérolami

  • 1Unité des Rickettsies, CNRS UMR 6020, Faculté de Médecine, Université de la Méditerranée, Marseille, France.

The Journal of Infectious Diseases
|September 10, 2003
PubMed
Summary

Patients with Whipple disease show a higher prevalence of Giardia duodenalis coinfection. This suggests a potential link between the two infections, possibly due to immune factors or shared transmission routes.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Whipple disease is a rare bacterial infection affecting the small intestine.
  • Giardia duodenalis is a common intestinal parasite.
  • The co-occurrence of these infections is not well-understood.

Purpose of the Study:

  • To investigate the prevalence of Giardia duodenalis in patients with Whipple disease.
  • To compare Giardia duodenalis prevalence in Whipple disease patients versus controls.
  • To explore potential reasons for coinfection.

Main Methods:

  • Histological examination of duodenal biopsy samples.
  • Polymerase chain reaction (PCR) assay for Giardia duodenalis DNA.
  • Literature review of coinfection cases.

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Main Results:

  • Histological evidence of giardiasis was found in 3/25 Whipple disease patients vs. 1/150 controls (P<.001).
  • PCR detected Giardia in 2/6 Whipple disease patients vs. 2/150 controls (P<.001).
  • Fifteen additional coinfection cases were identified in the literature.

Conclusions:

  • Giardia duodenalis coinfection is significantly more common in Whipple disease patients.
  • A shared immune defect or common source may facilitate coinfection.
  • One infection might increase susceptibility to the other.