Whipple's disease presenting with neurological symptoms in an immunosuppressed patient.
We report an unusual case of Whipple's disease, which remained undiagnosed for several years in a patient being treated with immunosuppressive therapy for many years. The patient presented with a purpuric rash, neurological symptoms, lymphadenopathy and gastrointestinal symptoms. The diagnosis was made by endoscopic biopsy of the duodenum with periodic acid Schiff staining, as well as PCR testing on blood and cerebrospinal fluid. The patient was successfully treated with intravenous ceftriaxone, followed by oral co-trimoxazole for 1 year.
Department of Neurology, Kennemer Gasthuis, Haarlem, Netherlands. weisfelt@kg.nl
Martijn
M
Weisfelt
Erik
E
Oosterwerff
Mirjam
M
Oosterwerff
Cees
C
Verburgh
D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D004386:Duodenum / Q000473:pathology*; D004576:Electromyography; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D016133:Polymerase Chain Reaction; D054851:Tropheryma / Q000235:genetics; D008061:Whipple Disease / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology
D004269:DNA, Bacterial