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07:36
Isolation of Human Lymphatic Endothelial Cells by Multi-parameter Fluorescence-activated Cell Sorting
Published on: May 1, 2015
[Unexplained lymphadenopathy: Whipple disease]
Caroline A Wientjes1, Sylvia A Luykx-de Bakker, M E F Eric Prins
1Tergooiziekenhuizen, locatie Hilversum, Afd. Interne Geneeskunde, Hilversum, The Netherlands. caroline@wientjes.org
Nederlands Tijdschrift Voor Geneeskunde
|November 26, 2009
Summary
This case study highlights a rare Whipple disease diagnosis in a 58-year-old man presenting with abdominal pain and lymphadenopathy. Prompt antibiotic therapy led to rapid improvement, underscoring the importance of considering this infection.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pathology
Background:
- Whipple disease is a rare, chronic bacterial infection caused by Tropheryma whipplei.
- The disease can present with diverse symptoms, often leading to delayed diagnosis.
Observation:
- A 58-year-old man initially presented with abdominal pain and lymphadenopathy, initially suspected as lymphoma.
- After 2.5 years, recurrent symptoms of weight loss, fever, and night sweats emerged, with CT showing progressive lymphadenopathy and hepatosplenomegaly.
Findings:
- Histopathology revealed macrophages with periodic acid-Schiff-stained rod-shaped bacteria, characteristic of Whipple disease.
- Polymerase chain reaction (PCR) and small intestine biopsies confirmed the diagnosis.
- Antibiotic treatment resulted in rapid clinical and biochemical recovery, with negative PCR after a year.
Implications:
- This case emphasizes the diagnostic challenges of Whipple disease due to its varied presentation.
- Early recognition and appropriate antibiotic therapy are crucial for successful management.
- Further research into Tropheryma whipplei pathogenesis and improved diagnostic markers is warranted.
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