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Neurological presentation of Whipple's disease after long-term antibiotic treatment: a case report

Felix Gundling1, Henning Wittenburg, Andrea Tannapfel

  • 1Second Department of Medicine, Bogenhausen Hospital, Academic Teaching Hospital, Technical University of Munich, Munich, Germany. Felix.Gundling@GMX.de

Journal of Medical Case Reports
|June 5, 2008
PubMed
Abstract

Insights

Whipple's disease, a rare infection by Tropheryma whipplei, can affect the central nervous system even after long-term antibiotic treatment. Meropenem may be an alternative treatment for relapsed cases.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Whipple's disease is a rare systemic infectious disorder caused by Tropheryma whipplei.
  • Central nervous system involvement can occur in Whipple's disease.
  • Long-term antibiotic therapy is a common treatment approach.

Purpose of the Study:

  • To report a case of central nervous system Whipple's disease in a patient with a history of long-term antibiotic therapy.
  • To discuss treatment options for relapsed or refractory central nervous system Whipple's disease.

Main Methods:

  • Case report of a 68-year-old male with central nervous system Whipple's disease.
  • Review of treatment outcomes with trimethoprim-sulfamethoxazole and meropenem.

Main Results:

  • The patient presented with central nervous system Whipple's disease many years after initial clinical onset and following long-term antibiotic therapy.
  • Trimethoprim-sulfamethoxazole did not prevent or cure central nervous system involvement in this patient.
  • Meropenem was considered a potential alternative treatment for central nervous system relapse.

Conclusions:

  • Standard antibiotic regimens may not always prevent or cure central nervous system Whipple's disease.
  • Meropenem shows promise as an alternative treatment for central nervous system relapses.
  • Further research is needed to optimize treatment strategies for central nervous system Whipple's disease.

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