Whipple’s disease

Tropheryma whipplei infection

infxn w/ T. whipplei (Lancet 2016;16:13)

Other s/s: fever, LAN, edema, arthritis, CNS Δs, gray-brown skin pigmentation, AI & MS, oculomasticatory myorhythmia (eye oscillations + mastication muscle contract).

Dx: bx/path, IHC, PCR. Rx: PCN + streptomycin or 3rd-gen ceph × 10–14 d → Bactrim ≥1 y.

• In patients with unexplained symptoms localized to the central nervous system, gastrointestinal tract, or joints, polymerase chain reaction testing for Tropheryma whipplei should be performed.

• 對於中樞神經系統、胃腸道 關節出現不明原因症狀的患者，應進行 Tropheryma whipplei 聚合酶鏈反應檢測。