title: Tropheryma whipplei endocarditis.
abstract: Tropheryma whipplei endocarditis differs from classic Whipple disease, which primarily affects the gastrointestinal system. We diagnosed 28 cases of T. whipplei endocarditis in Marseille, France, and compared them with cases reported in the literature. Specimens were analyzed mostly by molecular and histologic techniques. Duke criteria were ineffective for diagnosis before heart valve analysis. The disease occurred in men 40-80 years of age, of whom 21 (75%) had arthralgia (75%); 9 (32%) had valvular disease and 11 (39%) had fever. Clinical manifestations were predominantly cardiologic. Treatment with doxycycline and hydroxychloroquine for at least 12 months was successful. The cases we diagnosed differed from those reported from Germany, in which arthralgias were less common and previous valve lesions more common. A strong geographic specificity for this disease is found mainly in eastern-central France, Switzerland, and Germany. T. whipplei endocarditis is an emerging clinical entity observed in middle-aged and older men with arthralgia.
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.forename: Marie
authors.initials: M
authors.lastname: Célard
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lagier
authors.forename: Hubert
authors.initials: H
authors.lastname: Lepidi
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Fournier
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D005060:Europe; D006351:Heart Valves / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D054851:Tropheryma; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D007166:Immunosuppressive Agents
keywords: Tropheryma whipplei; Whipple disease; Whipple’s disease; arthralgia; bacteria; endocarditis