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Whipple's Disease: A Challenging Diagnosis
Beatriz Porteiro1, Ana Rita Freitas2, Filipa Nunes1
1Internal Medicine, Hospital Prof. Doutor Fernando Fonseca, Amadora, PRT.
Cureus
|February 12, 2024
Summary
Whipple's disease (WD), a rare bacterial infection, presents diverse symptoms and can mimic other conditions. Early diagnosis and antibiotic treatment, like ceftriaxone, are crucial for patient recovery.
Area of Science:
- Infectious Diseases
- Gastroenterology
Background:
- Whipple's disease (WD) is a rare, chronic, multisystemic infection caused by *Tropheryma whipplei*.
- WD diagnosis requires high clinical suspicion due to its varied and often nonspecific clinical manifestations.
Observation:
- A 65-year-old woman presented with migratory polyarthralgia, weight loss, anorexia, pyrosis, and bilateral deep vein thrombosis (DVT).
- Initial lymph node biopsy showed reactive lymphadenitis with intrahistiocytic bacilli, suggesting WD.
Findings:
- Whipple's disease was confirmed via small bowel biopsies.
- The patient showed rapid clinical improvement after initiating ceftriaxone treatment.
Implications:
- WD diagnostic challenges include nonspecific symptoms, often leading to misdiagnosis as rheumatic or neoplastic diseases.
- Deep vein thrombosis (DVT) is an unusual but reported manifestation of Whipple's disease, highlighting the need for broader diagnostic considerations.
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