Orbital manifestation of whipple's disease: an atypical case.
BACKGROUND
Whipple's disease is a systemic disorder caused by an infection with a gram-positive bacillus, Tropheryma whipplei. Almost every organ system can be affected in Whipple's disease, resulting in varying clinical symptoms.


METHODS
As far as we are aware, this report of a 61-year-old male is the first presenting with a periorbital manifestation of the disease, with severe exophthalmos and optic nerve involvement, leading to rapid visual loss. This emergency case was successfully treated by a surgical orbital decompression combined with systemic use of antibiotics and steroids.


CONCLUSIONS
Whipple's disease can affect the periorbital tissues and the optic nerve, causing massive exophthalmos and serious transient visual loss. In such a case surgical decompression of the affected orbit combined with antibiotics and steroids is a recommended valid treatment option.
Lieger
Olivier
O
Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland. olivier.lieger@insel.ch
Otto
Sven
S
Clemetson
Isabelle Ann
IA
Arnold
Marlene
M
Iizuka
Tateyuki
T
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D019299:Decompression, Surgical; D005094:Exophthalmos / Q000209:etiology; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology; D009901:Optic Nerve Diseases / Q000209:etiology; D009916:Orbital Diseases / Q000209:etiology*; D014786:Vision Disorders / Q000209:etiology; D008061:Whipple Disease / Q000150:complications*
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D002443:Ceftriaxone