title: Whipple's disease: a difficult diagnosis?
abstract: We present 3 patients with Whipple's disease all characterized by a longstanding prodromal period with progressive weight loss, diarrhoea, lymphadenitis and arthralgia or arthritis. Sarcoid-like Whipple's disease was diagnosed in one patient. He was treated with antibiotics. Initially his condition improved; however, a cerebral relapse developed which was treated successfully by ceftriaxone and cefixime. Extraintestinal Whipple's disease (lymph node localisation) was diagnosed in another patient treated successfully with antibiotics. A third case of Whipple's disease was unexpectedly diagnosed by laparotomy and partial small bowel resection. He was not treated till 2 years later with tetracycline. After 1 year of treatment his condition had improved.
authors.affiliation: Department of Gastroenterology, University Hospital Maastricht, Netherlands.
authors.forename: F P
authors.initials: FP
authors.lastname: Peters
authors.forename: E A
authors.initials: EA
authors.lastname: Elbrecht
authors.forename: R S
authors.initials: RS
authors.lastname: Wouters
authors.forename: L G
authors.initials: LG
authors.lastname: Engels
authors.forename: R W
authors.initials: RW
authors.lastname: Stockbrügger
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004386:Duodenum / Q000473:pathology; D005260:Female; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents