[Whipple's disease. Two new cases of an underdiagnosed disease].
Whipple's disease is a rare systemic infectious disease caused by the bacterium Tropheryma whippelii. Early diagnosis is essential. Whipple's disease is potentially fatal but responds dramatically to antibiotic treatment. The diagnosis is confirmed by means of polymerase chain reaction (PCR) technology. This analysis may be useful for monitoring the efficacy of therapy. The recommended treatment al present is administration of cotrimoxazole twice daily for one year. When CNS involvement occurs, it is recommended initial treatment with daily parenteral administration of streptomycin 1 g and 1.2 million units of benzyl penicillin (Penicillin G) over a period of 14 days.
Servicio de Medicina Interna I, Hospital Central de Asturias, Oviedo, Spain. anamartagb@hotmail.com
A M
AM
García Bernárdez
A I
AI
García Díez
C C
CC
Alvarez Cuesta
M
M
Gallego Villalobos
E
E
Vallina Alvarez
J M
JM
Arribas Castrillo
D000368:Aged; D000740:Anemia / Q000209:etiology; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000209:etiology; D001706:Biopsy; D004269:DNA, Bacterial / Q000302:isolation & purification; D003967:Diarrhea / Q000209:etiology; D004378:Duodenal Diseases / Q000209:etiology / Q000382:microbiology / Q000473:pathology; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006094:Gram-Positive Bacteria / Q000235:genetics / Q000302:isolation & purification; D006333:Heart Failure / Q000209:etiology; D006349:Heart Valve Diseases / Q000209:etiology / Q000601:surgery; D006801:Humans; D007813:Laparotomy; D008297:Male; D010400:Penicillin G / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D013307:Streptomycin / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D015431:Weight Loss; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy
D004269:DNA, Bacterial; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D005492:Folic Acid; D010400:Penicillin G; D013307:Streptomycin