Tropheryma whipplei endocarditis without gastrointestinal involvement

Area of Science:

• Infectious Diseases
• Cardiology
• Gastroenterology

Background:

• Whipple's disease is a rare, chronic, multi-system bacterial infection caused by Tropheryma whipplei.
• It commonly affects the gastrointestinal tract, presenting with diarrhea, weight loss, and malabsorption.
• Cardiac manifestations occur in 20-55% of patients, but isolated valvular disease without GI symptoms is rare.

Observation:

• This report details a rare case of Tropheryma whipplei native aortic and mitral valvular endocarditis.
• The patient presented with new-onset cardiac failure and ventricular arrhythmias, notably without any gastrointestinal symptoms.
• This presentation involved rare double-valve involvement.

Findings:

• The patient required urgent double-valve replacement due to severe valvular endocarditis.
• The findings underscore the atypical presentations of Whipple's disease.
• Literature review confirms the rarity of isolated cardiac Whipple's disease with double-valve involvement.

Implications:

• This case expands the understanding of Tropheryma whipplei's clinical spectrum.
• It emphasizes the importance of considering Whipple's disease in patients with unexplained valvular heart disease, even without GI symptoms.
• Early diagnosis and intervention are crucial for managing cardiac Whipple's disease.