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Case Report: Tropheryma whipplei Infection Presenting with Optic Disc Edema
Anju M Kanikunnel1, Scott A Anthony2, Eric S Eleff3
1Ophthalmology/Optometry Clinic, Central Texas Veterans Health Care System: Austin Outpatient Clinic, Austin, Texas.
Summary
Whipple disease, a rare bacterial infection, can cause vision-threatening optic disc edema. Early detection and treatment are crucial for preventing severe complications, including central nervous system involvement.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Gastroenterology
Background:
- Whipple disease is a rare, chronic, systemic bacterial infection primarily affecting the small intestine.
- Untreated Whipple disease can lead to severe complications, including vision and life-threatening central nervous system involvement.
Observation:
- A case report details a 49-year-old asymptomatic man with unilateral optic disc edema.
- Initial investigations for optic disc edema were inconclusive, ruling out common causes.
- The patient later developed diarrhea, weight loss, and fatigue, prompting further evaluation.
Findings:
- Comprehensive diagnostic workup, including GI biopsy and serological testing, confirmed Whipple disease.
- The patient's optic disc edema was identified as a critical early sign of the infection.
- Treatment with oral antibiotics successfully resolved the Whipple disease symptoms.
Implications:
- Unilateral optic disc edema can be a rare presenting sign of Whipple disease.
- A thorough medical evaluation is essential for diagnosing Whipple disease, especially when presenting with atypical symptoms.
- Prompt diagnosis and treatment of Whipple disease are vital to prevent severe systemic and neurological complications.
