[A rare cause of recurrent monarthritis of the knee]

Area of Science:

• Microbiology
• Rheumatology
• Infectious Diseases

Background:

• Whipple's disease is typically associated with gastrointestinal and systemic symptoms.
• Isolated joint involvement without GI signs is an uncommon presentation.
• Early diagnosis is crucial for effective treatment and management.

Observation:

• A male patient presented with recurrent, long-standing knee joint arthritis.
• Gastrointestinal or other systemic symptoms were notably absent.
• Synovial tissue and fluid biopsies were analyzed for causative agents.

Findings:

• Polymerase Chain Reaction (PCR) testing of synovial biopsies confirmed Tropheryma whipplei.
• The patient was identified as an asymptomatic carrier of T. whipplei.
• The diagnosis of Whipple's disease was established based on joint findings.

Implications:

• This case highlights the importance of considering Whipple's disease in monoarthritis, even without GI involvement.
• PCR analysis of synovial fluid is a valuable diagnostic tool for Tropheryma whipplei.
• Successful treatment with antibiotics led to complete recovery, underscoring the efficacy of timely intervention.