[First centenary of Whipple's disease]

Area of Science:

• Infectious Diseases
• Microbiology
• Gastroenterology

Context:

• Whipple's disease is a rare, multisystemic infection caused by Tropheryma whippelii.
• The bacterium, identified as an actinomycete via 16S rRNA, presents with diverse symptoms including diarrhea, weight loss, abdominal pain, and arthralgias.
• Immunological abnormalities often precede or accompany clinical manifestations.

Purpose:

• To summarize the key aspects of Whipple's disease, covering its causative agent, clinical presentation, diagnostic methods, and treatment options.
• To provide an overview of the current understanding and management of this infrequent infection.

Summary:

• Whipple's disease is caused by Tropheryma whippelii, a gram-positive bacterium.
• Principal symptoms include diarrhea, weight loss, abdominal pain, and arthralgias, potentially progressing to digestive, cardiovascular, and neurological issues.
• Diagnostic tools include duodenal biopsy (Schiff test, PCR, electron microscopy, immunohistochemistry), alongside cabinet, endoscopic, radiological, and tomographic studies.
• Treatment primarily involves trimethoprim/sulfamethoxazole, with transfer factor as a potential adjunct.

Impact:

• Enhances understanding of a rare infectious disease.
• Highlights the importance of multi-faceted diagnostic approaches.
• Informs clinical management strategies for Whipple's disease.