MRI of recurrent isolated cerebral Whipple's disease.
Whipple's disease is a rare systemic bacterial infection, characterized predominantly by gastrointestinal symptoms. Neurological symptoms are frequent in the course of the disease; however, a purely neurological presentation is uncommon. Diagnosis is confirmed with biopsy and polymerase chain reaction studies. Magnetic resonance imaging (MRI) findings vary, most commonly showing increased signal intensity on T2-weighted images. Contrast-enhanced images and diffusion- weighted imaging are useful to demonstrate meningeal enhancement and any accompanying infarcts. Brain biopsy is often performed, and MRI is crucial to guide the biopsy. Cerebral Whipple's disease is a long-lasting infection requiring long-term follow-up of these patients. MRI should be performed to detect any potential recurrence. We present a case of recurrent isolated cerebral Whipple's disease in a 68-year-old man with atypical presentation and MRI findings.
Department of Radiology, Başkent University School of Medicine, Ankara, Turkey. fuldemyildirim@yahoo.com
Fuldem Yildirim
FY
Dönmez
Esra
E
Ulu
Ceyla
C
Başaran
Müge
M
Unlükaplan
Arzu
A
Uyuşur
Mahir
M
Yildirim
Esra
E
Ozgül
D000368:Aged; D001921:Brain / Q000473:pathology*; D003221:Confusion / Q000209:etiology; D003287:Contrast Media; D005334:Fever; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008578:Meninges / Q000473:pathology; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D010296:Parietal Lobe / Q000473:pathology; D012008:Recurrence; D013702:Temporal Lobe / Q000473:pathology; D008061:Whipple Disease / Q000473:pathology*
D003287:Contrast Media