[Weight loss, dementia and ataxia susceptible to doxycycline: a likely new case report caused by T. whipplei].
BACKGROUND
Whipple's disease is a rare infectious disease due to Tropheryma whipplei, a bacterium rarely causing severe localized neurological infection (only 25 cases reported in the literature), which are more often diagnosed by a positive T. whipplei PCR performed on cerebrospinal fluid.


METHODS
We report the third case of progressive dementia associated with obesity and ataxia in a 52-year-old man. Classic laboratory results performed to identify the etiology of the clinical features were non-contributive: only a saliva T. whipplei PCR was strongly positive and the Western blot serology has detected an asymptomatic carriage profile. The (18)FDG-PET highlighted a frontal area hypometabolism. An antibiotic treatment by doxycycline allowed a partial regression of the neurological manifestations, a weight loss and a significant improvement of the (18)FDG frontal hypometabolism.


CONCLUSIONS
Progressive dementia associated with ataxia and obesity is a new clinical syndrome caused by T. whipplei. Antibiotic test by doxycycline can help to the diagnosis and (18)-FDG could facilitate the follow-up.
Faculté de médecine, Aix-Marseille université, URMITE, UM63, CNRS 7278, IRD 198, Inserm 1095, 27, boulevard Jean-Moulin, 13005 Marseille, France; Pôle infectieux, CHU Timone, AP-HM, 13005 Marseille, France.
J-C
JC
Lagier
F
F
Fenollar
L
L
Koric
E
E
Guedj
M
M
Ceccaldi
D
D
Raoult
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001259:Ataxia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004318:Doxycycline / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D054851:Tropheryma / Q000502:physiology; D015430:Weight Gain / Q000187:drug effects; D008061:Whipple Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D004318:Doxycycline
(18)FDG-PET; Doxycyclin; Doxycycline; Maladie de Whipple; PET-scanner au (18)FDG; Tropheryma whipplei; Whipple's disease