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A rare course of Whipple's disease with atypical cardiac manifestation

S Gunia1, M H Behrens, P Stosiek

  • 1Institut für Pathologie, Carl-Thiem-Klinikum, Cottbus, Germany. S.Gunia@ctk.de

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|May 22, 2004
PubMed

Insights

Whipple's disease, a rare infection, can cause severe cardiac issues. This case highlights Tropheryma whippelii causing myocarditis and cardiac death, a previously unreported manifestation.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pathology

Background:

  • Whipple's disease (WD) is a rare chronic systemic infection caused by Tropheryma whippelii.
  • The oral route is the presumed acquisition pathway for WD.
  • WD is characterized by foamy, PAS-positive macrophages in affected tissues.

Observation:

  • A case report details a woman with atypical cardiac manifestations of WD.
  • The patient experienced severe cardiac impairment due to Tropheryma whippelii infection.
  • Autopsy revealed PAS-positive macrophages in myocardial fibrotic foci.

Findings:

  • Polymerase chain reaction confirmed Tropheryma whippelii in myocardial tissue.
  • Histological analysis showed interstitial myocardial fibrosis.
  • Immunohistochemistry revealed myocarditis with lymphocytes and neutrophilic granulocytes, a novel finding in WD.

Implications:

  • This case expands the understanding of Whipple's disease clinical presentations.
  • It underscores the potential for Tropheryma whippelii to cause severe, previously unreported cardiac pathology.
  • Highlights the importance of considering WD in cardiac impairment cases, even with atypical symptoms.

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