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Sudden death in Whipple's disease
P McGettigan1, E E Mooney, M Sinnott
1Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland Department of Pharmacology and Therapeutics.
Abstract:
Despite antibiotic therapy, some patients with uncomplicated Whipple's disease die suddenly and inexplicably. We describe one such patient who died following unexplained cardiorespiratory arrest and was found to have chronic active myocarditis related to the causative organism. We postulate myocarditis as a cause of sudden death.
Insights
Sudden unexplained deaths in Whipple's disease patients may be caused by heart inflammation. This study found chronic active myocarditis related to the disease's bacteria in a patient who died suddenly.
Area of Science:
- Infectious Diseases
- Cardiology
- Pathology
Background:
- Whipple's disease is a rare bacterial infection typically treated with antibiotics.
- Despite treatment, some patients experience sudden, unexplained deaths.
- The underlying cause of these fatalities remains unclear.
Observation:
- A patient with Whipple's disease experienced sudden cardiorespiratory arrest despite antibiotic therapy.
- Post-mortem examination revealed chronic active myocarditis linked to the causative organism, Tropheryma whipplei.
Findings:
- Chronic active myocarditis associated with Tropheryma whipplei infection was identified in a patient with fatal Whipple's disease.
- The cardiac inflammation was directly related to the bacterial pathogen responsible for the gastrointestinal disease.
Implications:
- Myocarditis may be an underrecognized cause of sudden cardiac death in patients with Whipple's disease.
- This finding suggests the need for cardiac evaluation in Whipple's disease patients presenting with unexplained cardiorespiratory symptoms.
- Further research is warranted to understand the prevalence and mechanisms of myocarditis in Whipple's disease.