Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- 43 Acute viral hepatitis
- 44 Chronic hepatitis
- 45 Biliary infection: cholecystitis and cholangitis
- 46 Pyogenic liver abscess
- 47 Infectious complications of acute pancreatitis
- 48 Esophageal infections
- 49 Gastroenteritis
- 50 Food poisoning
- 51 Antibiotic-associated diarrhea
- 52 Sexually transmitted enteric infections
- 53 Acute appendicitis
- 54 Diverticulitis
- 55 Abdominal abscess
- 56 Splenic abscess
- 57 Peritonitis
- 58 Whipple’s disease
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
58 - Whipple’s disease
from Part VII - Clinical syndromes: gastrointestinal tract, liver, and abdomen
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- 43 Acute viral hepatitis
- 44 Chronic hepatitis
- 45 Biliary infection: cholecystitis and cholangitis
- 46 Pyogenic liver abscess
- 47 Infectious complications of acute pancreatitis
- 48 Esophageal infections
- 49 Gastroenteritis
- 50 Food poisoning
- 51 Antibiotic-associated diarrhea
- 52 Sexually transmitted enteric infections
- 53 Acute appendicitis
- 54 Diverticulitis
- 55 Abdominal abscess
- 56 Splenic abscess
- 57 Peritonitis
- 58 Whipple’s disease
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
In 1907, Dr. George H. Whipple, a pathologist at Johns Hopkins Hospital, described the first case of “intestinal lipodystrophy” in a 36-year-old male physician with symptoms of chronic diarrhea, abdominal pain, weight loss, and chronic cough. The patient succumbed to his death after 5 years of his disease. Universally fatal prior to the advent of antibiotics, the condition now known as Whipple’s disease has accumulated case reports and case series with a recent prospective study in the management of the disease. This rare disease masquerades as a multisystem condition of symptoms that are nonspecific, rendering the diagnosis inaccessible unless included in the differential diagnosis. Based on the most recent prospective study, the disease is well managed with appropriate attention to diagnosis and antibiotic therapy.
After the initial case report by Dr. Whipple, progress was made towards establishing the means of diagnosis and treatment. In 1949, periodic acid–Schiff (PAS) staining helped identify the red appearance of glycoproteins within intestinal macrophages. Shortly afterwards, the first microscopic identification of a bacteria-like organism led to the first successful treatment of Whipple’s disease with chloramphenicol. Electron microscopy and the advancement of histologic staining helped further characterize the infectious entity as a gram-positive bacterium. In 1992, polymerase chain reaction (PCR) was used to identify the ribosomal RNA of the organism, classifying it as an actinomycete. Genomic sequencing of the organism in 2003 has brought us to the current classification of this rod-shaped, gram-positive actinomycete as Tropheryma whipplei.
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- Clinical Infectious Disease , pp. 381 - 384Publisher: Cambridge University PressPrint publication year: 2015