title: Tropheryma whipplei endocarditis without gastrointestinal involvement.
abstract: Whipple's disease, caused by the bacterium Tropheryma whipplei, is a rare chronic multi-system illness commonly affecting the gastrointestinal (GI) tract and presenting with a triad of diarrhoea, weight loss and malabsorption. While 20-55% of patients with a diagnosis of Whipple's disease have clinically evident cardiac manifestations, the initial presentation with isolated valvular disease, without any GI symptoms, is rare. Whereas cardiac involvement usually involves a single valve, cases of double-valve involvement are extremely rare. We report the case of a patient with T. whipplei native aortic and mitral valvular endocarditis, without GI involvement, who presented with the new-onset cardiac failure and ventricular arrhythmias, which required urgent double-valve replacement. This case report is accompanied by a review of the relevant literature.
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool,  UK.
authors.forename: Susannah M
authors.initials: SM
authors.lastname: Love
authors.forename: Lindsay
authors.initials: L
authors.lastname: Morrison
authors.forename: Clare
authors.initials: C
authors.lastname: Appleby
authors.forename: Paul
authors.initials: P
authors.lastname: Modi
mesh_terms: D001021:Aortic Valve / Q000382:microbiology* / Q000601:surgery; D001145:Arrhythmias, Cardiac / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006333:Heart Failure / Q000382:microbiology; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology* / Q000601:surgery; D016896:Treatment Outcome; D054851:Tropheryma / Q000302:isolation & purification*; D008061:Whipple Disease / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery