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Ocular involvement in Whipple's disease.

E J Selsky, D L Knox, A E Maumenee

Retina (Philadelphia, Pa.)

|January 1, 1984

Summary

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This study details a rare case of Whipple's disease presenting with eye symptoms. Diagnosis was confirmed years later via vitreous biopsy, highlighting the importance of considering this condition in ocular manifestations.

Area of Science:

Ophthalmology
Infectious Diseases
Rheumatology

Background:

Whipple's disease is a rare systemic bacterial infection typically affecting the gastrointestinal tract.
Ocular manifestations, though uncommon, can be the initial or sole presenting sign.

Observation:

A 60-year-old man presented with bilateral vitreous opacities and arthritis, initially suggestive of Whipple's disease.
Initial treatment with antibiotics (tetracycline and erythromycin) provided symptomatic relief.

Findings:

A vitreous aspirate 13 years later confirmed Whipple's disease through histopathology (PAS-positive macrophages) and electron microscopy (bacilli).
This case underscores the diagnostic challenges and prolonged course of Whipple's disease.

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Implications:

Ocular findings, such as vitreous opacities, should prompt consideration of Whipple's disease, even without classic gastrointestinal symptoms.
Early recognition and appropriate diagnostic methods are crucial for managing this rare infectious disease.
Long-term follow-up is essential given the potential for delayed diagnosis and recurrence.