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Whipple disease

Elan D Louis1

  • 1Neurological Institute, Columbia University College of Physicians & Surgeons, 710 West 168th Street, Unit 198, New York, NY 10032, USA. EDL2@columbia.edu

Current Neurology and Neuroscience Reports
|October 21, 2003
PubMed

Insights

Whipple disease, a rare bacterial infection, presents with systemic and neurological symptoms. Diagnosis utilizes clinical findings, biopsy, and sensitive polymerase chain reaction (PCR) testing, guiding a year-long antibiotic treatment.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Neurology

Background:

  • Whipple disease is a rare systemic infection caused by the bacterium Tropheryma whippelii.
  • Humans are the only known host, with manifestations including gastrointestinal issues, weight loss, arthritis, and central nervous system disorders.
  • Neurological signs encompass cognitive changes, gaze palsy, altered consciousness, and movement disorders.

Purpose of the Study:

  • To summarize the key aspects of Whipple disease, including its causative agent, clinical presentation, diagnostic methods, and treatment protocols.

Main Methods:

  • Diagnosis relies on clinical evaluation, microscopic examination of biopsy specimens, and polymerase chain reaction (PCR) analysis.
  • PCR offers high sensitivity and specificity for detecting Tropheryma whippelii.
  • Recent advancements include successful culturing of the organism, though historically challenging.

Main Results:

  • Tropheryma whippelii infection leads to a spectrum of systemic and neurological symptoms.
  • Polymerase chain reaction (PCR) analysis is a highly sensitive and specific diagnostic tool.
  • Successful culturing of the bacterium has been achieved recently.

Conclusions:

  • Whipple disease requires a comprehensive diagnostic approach combining clinical, histological, and molecular methods.
  • A 1-year antibiotic regimen is recommended for treatment.
  • Monitoring clinical signs and cerebrospinal fluid PCR results is crucial during treatment.

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