Whipple Disease With Central Nervous System Involvement.

Phi Tran, Juan Negron-Diaz, Hector Ramirez
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Abstract

Background: Whipple disease is a rare, chronic, and systemic infectious disease caused by the bacterium Tropheryma whipplei. It can be mistaken for numerous other diseases, including seronegative rheumatoid arthritis and tropical sprue, and it is known to occur concurrently with giardiasis. Whipple disease can be fatal if not promptly recognized and treated.

Case presentation: A 53-year-old male presented with an 8-month history of persistent diarrhea, memory distortion, visual disturbances, 30-lb weight loss, and intermittent bilateral hand and knee arthralgias. An autoimmune evaluation for arthralgia was negative. Polymerase chain reaction testing of duodenal biopsy tissue and cerebrospinal fluid was positive for Tropheryma whipplei.

Conclusions: Whipple disease should be considered in the differential diagnosis when patients present with chronic seronegative arthritis, gastrointestinal abnormalities, and cognitive changes. This case, along with others reported in the literature, point to the importance of additional testing for Whipple disease, even when a concurrent infection, such as giardiasis, has been identified.

惠普尔病累及中枢神经系统。
背景:惠普尔病是一种罕见的慢性全身性感染性疾病,由惠普尔滋养菌引起。它可能被误认为许多其他疾病,包括血清阴性类风湿关节炎和热带口疮,并且已知它与贾第虫病同时发生。如果不能及时发现和治疗,惠普尔病可能是致命的。病例介绍:53岁男性,持续腹泻、记忆扭曲、视力障碍、体重减轻30磅,伴有间歇性双侧手膝关节痛,病史8个月。关节痛的自身免疫评估为阴性。十二指肠活检组织及脑脊液聚合酶链反应阳性。结论:当患者出现慢性血清阴性关节炎、胃肠道异常和认知改变时,应考虑惠普尔病的鉴别诊断。这一病例,连同其他文献报道的病例,都表明了对惠普尔病进行额外检测的重要性,即使并发感染,如贾第虫病,已经被确定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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