title: Isolated Whipple's endocarditis: an underestimated diagnosis that requires molecular analysis of surgical material.
abstract: Tropheryma whipplei is known as the bacterium that causes Whipple's disease, a rare systemic illness typically affecting gastrointestinal tract, joints, and central nervous system. In addition, T whipplei infection may present as an isolated endocarditis. Although previously regarded as a rare condition, T whipplei has been recognized as a major cause of culture-negative endocarditis when integrating specific molecular analysis of surgical material into the diagnostic algorithm. Here, we report the case of a 67-year-old man undergoing mitral valve replacement due to T whipplei endocarditis, and discuss diagnostic and therapeutic implications.
authors.affiliation: Institute of Pathology, University of Ulm, Ulm, Germany; Institute of Molecular Life Sciences, University of Zurich, Zurich, Switzerland.
authors.forename: Markus D
authors.initials: MD
authors.lastname: Herrmann
authors.affiliation: Department of Cardiac and Thoracic Surgery, University of Ulm, Ulm, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Neumayr
authors.affiliation: Institute of Medical Microbiology and Hygiene, University of Ulm, Ulm, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Essig
authors.affiliation: Department of Cardiology, University of Ulm, Ulm, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Spiess
authors.affiliation: Department of Cardiac and Thoracic Surgery, University of Ulm, Ulm, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Merk
authors.affiliation: Institute of Molecular Life Sciences, University of Zurich, Zurich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Möller
authors.affiliation: Department of Cardiac and Thoracic Surgery, University of Ulm, Ulm, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Liebold
authors.affiliation: Institute of Pathology, University of Ulm, Ulm, Germany. Electronic address: thomas.barth@uniklinik-ulm.de.
authors.forename: Thomas F E
authors.initials: TF
authors.lastname: Barth
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis*; D003937:Diagnosis, Differential; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D054851:Tropheryma / Q000235:genetics* / Q000302:isolation & purification; D008061:Whipple Disease / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial