[From stroke via swollen joints to M. Whipple: case report from neurological rehabilitation and review of literature].

Abstract

Whipple's disease is a rare systemic disease caused by a chronic infection with Tropheryma whipplei, which can often only be diagnosed years after the first symptoms appear. The symptoms are varied and sometimes unspecific. In addition to cachexia, recurrent joint swelling and abdominal complaints, neurological symptoms with dementia, myoclonus and motor neuron disease also occur. In the reported case, symptoms such as joint swelling and spasms of the legs occurred during neurological rehabilitation following a paramedian pons infarction. The close collaboration between the neurological rehabilitation physicians and rheumatology colleagues made it possible to diagnose Whipple's disease. Guideline-compliant treatment with ceftriaxone followed by sulfamethoxazole-trimethoprim was initiated. This improved the joint effusions and, surprisingly, also the spasms of the legs within a few days.