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Pancarditis in Whipple's disease: electronmicroscopic demonstration of intracardiac bacillary bodies
Abstract:
The advent of electron microscopy has repeatedly confirmed Whipple's original postulate that bacterial infestation might be the cause of intestinal lipodystrophy (Whipple's disease). We have recently studied two patients, a 67-year-old man and a 38-year-old woman, who died of untreated Whipple's disease, and both were found to have clinically unrecognized pancarditis. Histologically, PAS-positive histiocytes in foci of chronic inflammation were demonstrable in several organs, including the heart. Electron microscopy of autopsy tissues showed numerous intracellular and extracellular rod-shaped bacillary bodies and serpiginous membranes. The bacillary bodies, some sectioned transversely and others longitudinally, were about 0.2 mum wide and 2 mum long; each had a double-layered cell wall. These bacillary bodies have not been previously identified in the heart, and may be casually related to cardiac lesions occurring in many untreated cases of Whipple's disease.
Insights
Electron microscopy confirmed bacteria in Whipple's disease patients, revealing previously unidentified bacillary bodies in the heart. These findings suggest a link between these cardiac bacterial infections and heart damage in untreated Whipple's disease.
Area of Science:
- Microbiology
- Pathology
- Cardiology
Background:
- Whipple's disease is a rare infectious disease caused by bacteria.
- Electron microscopy has previously supported the bacterial cause of Whipple's disease.
- Cardiac involvement in Whipple's disease is often clinically unrecognized.
Purpose of the Study:
- To investigate the presence and characteristics of bacteria in the heart tissues of patients with untreated Whipple's disease.
- To determine if previously unidentified bacterial structures are present in cardiac lesions.
Main Methods:
- Autopsy tissues from two patients with untreated Whipple's disease were examined.
- Histological analysis included Periodic Acid-Schiff (PAS) staining to identify characteristic histiocytes.
- Electron microscopy was used to visualize intracellular and extracellular bacterial structures.
Main Results:
- PAS-positive histiocytes were found in various organs, including the heart.
- Electron microscopy revealed numerous rod-shaped bacillary bodies (0.2 x 2 µm) with double-layered cell walls within and outside cells.
- These bacillary bodies were identified in cardiac tissues for the first time.
Conclusions:
- The study identified novel bacterial structures in the heart of Whipple's disease patients.
- These findings suggest a potential causal relationship between these cardiac bacterial infections and heart lesions observed in untreated Whipple's disease.