title: Diffuse cortical lesions with hemorrhage in cerebral Whipple's disease.
abstract: A 30-year-old Chinese male with a history of diarrhea and arthralgia presented for evaluation of progressive dementia, epilepsy, and increased intracranial pressure. Imaging of the brain showed progressive cortical and subcortical lesions with hemorrhage involving the bilateral temporal and occipital lobes, the posterior parietal lobes, and the left frontal lobe. "Foamy" periodic acid-Schiff (PAS)-positive macrophages were demonstrated on brain biopsy. The patient showed clinical improvement following treatment with chloromycetin and sulfadiazine for 2 months. This constitutes the first reported case of cerebral Whipple's disease with diffuse cortical lesions with hemorrhage reported in a Chinese individual. Further, this case points out the significance of early recognition and treatment of cerebral Whipple's disease, especially in those cases with unusual manifestations.
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, PR China.
authors.forename: Liyong
authors.initials: L
authors.lastname: Wu
authors.forename: Xiangbo
authors.initials: X
authors.lastname: Wang
authors.forename: Hua
authors.initials: H
authors.lastname: Wei
authors.forename: Cunjiang
authors.initials: C
authors.lastname: Li
authors.forename: Jianping
authors.initials: J
authors.lastname: Jia
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008061:Whipple Disease / Q000150:complications* / Q000473:pathology* / Q000628:therapy