Whipple's syndrome (uveitis, B27-negative spondylarthropathy, meningitis, and lymphadenopathy) associated with Arthrobacter sp. infection.
OBJECTIVE
To report an unusual case of Whipple's disease, including uveitis, seronegative spondylarthropathy, meningitis, and lymphadenopathy, associated with an Arthrobacter sp. infection.


METHODS
Interventional case report.


METHODS
A 60-year-old white man presenting with severe chronic uveitis and systemic inflammatory manifestations was treated efficiently for Whipple's disease after histopathologic analysis of vitreous and inguinal adenopathy biopsy specimens. The authors performed a retrospective, laboratory-based evaluation of stored tissue specimens.


METHODS
Molecular analysis based on 16S ribosomal RNA gene amplification was applied to pretreatment biopsy specimens of inguinal lymph node to identify a causative bacterial agent.


RESULTS
Tropheryma whippelii genome was not detected in these specimens. However, an amplification product was obtained after the first polymerase chain reaction run and subsequently was sequenced. It corresponded to an Arthrobacter sp., a gram-positive agent presenting diagnostic patterns and therapeutic management similar to those of Whipple's disease caused by T. whippelii.


CONCLUSIONS
The absence of T. whippelii identification by molecular amplification during a clinically and histologically oriented Whipple's syndrome should not rule out the diagnosis. Arthrobacter infection may represent a new bacterial etiology of systemic inflammatory disorders involving the eye and associated with periodic acid-Schiff-positive inclusions.
Bodaghi
B
B
Department of Ophthalmology, Hôpital Pitié-Salpêtrière, Paris, France.
Dauga
C
C
Cassoux
N
N
Wechsler
B
B
Merle-Beral
H
H
Poveda
J D
JD
Piette
J C
JC
LeHoang
P
P
D001173:Arthrobacter / Q000235:genetics*; D002908:Chronic Disease; D004275:DNA, Ribosomal / Q000032:analysis; D005784:Gene Amplification; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000382:microbiology*; D015796:HLA-B27 Antigen / Q000032:analysis*; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000382:microbiology*; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D008875:Middle Aged; D010503:Periodic Acid-Schiff Reaction; D016133:Polymerase Chain Reaction; D012329:RNA, Bacterial / Q000032:analysis; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000382:microbiology*; D014605:Uveitis / Q000175:diagnosis / Q000382:microbiology*; D008061:Whipple Disease / Q000175:diagnosis / Q000382:microbiology*
D004275:DNA, Ribosomal; D015796:HLA-B27 Antigen; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S