title: Tropheryma whipplei and Whipple's disease.
abstract: Since its identification, information concerning Tropheryma whipplei, the causative agent of Whipple's disease (WD), has increased. Although T. whipplei is commonly infecting humans, WD is rare. The bacterium is most likely transmitted among humans via the oro-oral and the feco-oral routes. Infections result in chronic conditions such as asymptomatic carriage, disseminated Whipple's disease, which is usually preceded by arthralgias, and localized infections, such as endocarditis or encephalitis. T. whipplei is associated with acute infections including gastroenteritis, pneumonia, and/or bacteremia. Screening, based on the combined analyses of saliva and stool specimens using specific quantitative PCR, is useful if WD is suspected. Doxycycline and hydroxychloroquine for 12 months is the best treatment for WD; it should be followed by life-long treatment with doxycycline, as potentially fatal relapses can occur. T. whipplei seems to be an opportunistic bacterium that causes chronic infections in susceptible patients with as yet unknown predisposing factors.
authors.affiliation: Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; AP-HM, CHU Timone, Pôle Infectieux, 13005 Marseille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.affiliation: Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; AP-HM, CHU Timone, Pôle Infectieux, 13005 Marseille, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lagier
authors.affiliation: Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UM63, CNRS 7278, IRD 198, Inserm 1095, 13005 Marseille, France; AP-HM, CHU Timone, Pôle Infectieux, 13005 Marseille, France. Electronic address: didier.raoult@gmail.com.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis; D004696:Endocarditis / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005759:Gastroenteritis / Q000382:microbiology; D006801:Humans; D011014:Pneumonia / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000382:microbiology; D054851:Tropheryma / Q000302:isolation & purification*; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Encephalitis; Endocarditis; Gastroenteritis; Tropheryma whipplei; Whipple's disease