[Clinical case of the month. Whipple's disease: inaugural psychiatric symptoms].
First considered to be a metabolic illness of the gastro-intestinal tract, Whipple's disease has progressively been recognized as a systemic bacterial disorder due to Tropheryma Whippelii and responding to antibiotics. Neurological symptoms occur in 10 to 20% of cases either initially or during the disease course. Involvement of the central nervous system alone is rare. Modern molecular biology methods, i.e. PCR amplification of 16S rRNA can be applied to accessible biological fluids and/or tissue allowing an early diagnosis, which can lead to earlier administration of adequate antibiotics as well as to a more accurate monitoring of disease evolution. We report a patient suffering from Whipple's disease and presenting initially with severe mental and behavioral disturbances which were thought to be due to a psychiatric disorder.
Herrera
C
C
Service Universitaire de Neurologie, CHR-Citadelle, Liège.
Myressiotis
S
S
Schoenen
J
J
Ansseau
M
M
D000293:Adolescent; D000374:Aggression; D000855:Anorexia / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000188:drug therapy*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D008061:Whipple Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology*
D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S
Le cas clinique du mois. Maladie de Whipple: tableau psychiatrique inaugural.