Whipple disease presenting as posterior uveitis without prominent gastrointestinal symptoms.
OBJECTIVE
To describe the clinical presentation and course of Whipple disease in an adult.


METHODS
A 34-year-old man with phthisis bulbi in the right eye secondary to uveitis-induced neovascular glaucoma presented with severe acute posterior uveitis in the left eye. He underwent esophagogastroduodenoscopy and jejunal biopsy for evaluation of anemia. The posterior uveitis was treated with a subtenon injection of triamcinolone.


RESULTS
The diagnosis of Whipple disease was confirmed by polymerase chain reaction analysis of the jejunal biopsy that demonstrated Tropheryma whippelii rDNA.


CONCLUSIONS
Although Whipple disease is typically evident with malabsorption, it can also present as uveitis without prominent gastrointestinal symptoms.
Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
J K
JK
Nishimura
B E
BE
Cook
J M
JM
Pach
D039903:Actinobacteria / Q000235:genetics / Q000302:isolation & purification; D000193:Actinomycetales Infections / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D004359:Drug Therapy, Combination; D016145:Endoscopy, Digestive System; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007583:Jejunum / Q000382:microbiology / Q000473:pathology; D008297:Male; D016133:Polymerase Chain Reaction; D014222:Triamcinolone Acetonide / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D015866:Uveitis, Posterior / Q000175:diagnosis* / Q000188:drug therapy; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D005938:Glucocorticoids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014222:Triamcinolone Acetonide