AI Article Synopsis
- Whipple disease (WD) is a rare illness caused by the bacteria Tropheryma whipplei, typically affecting middle-aged men who show symptoms like fever, chronic diarrhea, and joint pain.
- Extragastrointestinal symptoms can occur, making it crucial to maintain a high suspicion for WD in atypical cases; diagnosis often requires histologic examination.
- Effective treatment for WD is with trimethoprim-sulfamethoxazole, as demonstrated in two patients who presented with uncommon symptoms like melena and prolonged depression, both of whom improved with the medication.
Article Abstract
Whipple disease (WD) is a rare disease caused by Tropheryma whipplei. The classic profile of the patient is that of a middle-aged man presenting with fever, chronic diarrhea, and arthralgias. Extragastrointestinal manifestations are not rare. A high degree of clinical suspicion for the disease is needed in atypical cases. Trimethoprim-sulfamethoxazole is the treatment of choice. We present two patients with WD. The first presented with melena and generalized hyperpigmentation. The second had depression for two years before the typical symptoms. Both hyperpigmentation and long-lasting depression without the typical manifestations of the disease are rare. Histologic examination of tissue biopsies was diagnostic for WD. Both patients were treated successfully with trimethoprim-sulfamethoxazole.
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| http://dx.doi.org/10.1097/SMJ.0b013e3181d3949c | DOI Listing |
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