title: [Whipple's disease].
abstract: A 36-year-old woman presented with fever, diarrhea, and weight loss in April 2011. Upper GI endoscopy and colonoscopy showed a diffuse yellow-white shaggy mucosa in the second part of the duodenum and the ileum end, respectively. These lesions in these 2 locations were biopsied, and both specimens showed distended epithelial villi and massive infiltration of foamy macrophages in the lamina propria. PCR was performed to identify causative bacilli. DNA extracted from the duodenal mucosa showed a specific PCR product, confirming the diagnosis of Whipple's disease. The patient was treated with a 2-week course of ceftriaxone, followed by sulfamethoxazole/trimethoprim. After we started the treatment, the patient developed complications of infective endocarditis and meningitis. The patient was relieved of her symptoms using a combination of gentamicin, penicillin G, ampicillin, meropenem, and vancomycin.
authors.affiliation: Showa University Yokohama Northern Hospital, Japan. D.W.colon@gmail.com
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watanabe
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Kakimoto
authors.forename: Kenta
authors.initials: K
authors.lastname: Kodama
authors.forename: Nobunao
authors.initials: N
authors.lastname: Ikehara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ohtsuka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mikogami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kimura
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Fukuchi
authors.forename: Fukunori
authors.initials: F
authors.lastname: Kinjo
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
mesh_terms: D000328:Adult; D004696:Endocarditis / Q000209:etiology; D005260:Female; D006801:Humans; D016920:Meningitis, Bacterial / Q000209:etiology; D008061:Whipple Disease / Q000150:complications / Q000175:diagnosis*