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Ocular involvement in Whipple's disease: light and electron microscopic observations
Archives of Ophthalmology (Chicago, Ill. : 1960)
|August 1, 1978
Summary
Whipple's disease can affect the eyes, causing vision loss and neurological symptoms. This case highlights the importance of considering Whipple's disease in patients with unexplained retinitis and vitreitis.
Area of Science:
- Ophthalmology
- Neurology
- Infectious Diseases
Background:
- Whipple's disease is a rare systemic bacterial infection typically affecting the gastrointestinal tract and joints.
- Ocular and neurological manifestations are less common but can be severe.
Observation:
- A 52-year-old man presented with migratory polyarthritis, pericarditis, followed by bilateral vitreitis and retinitis.
- The patient experienced progressive vision loss, lethargy, and dementia, ultimately leading to death.
Findings:
- Postmortem examination of the eyes revealed PAS-positive macrophages in the retina and vitreous.
- Electron microscopy identified intracytoplasmic, degenerating, rod-shaped bacteria within macrophages, consistent with Whipple's disease.
Implications:
- Whipple's disease should be considered in the differential diagnosis of bilateral retinitis and vitreitis, particularly with central nervous system involvement.
- Early diagnosis and treatment may be crucial for preventing severe visual and neurological sequelae.