title: Positron emission tomography in the diagnosis of Whipple's endocarditis: a case report.
abstract: BACKGROUND
  Whipple's disease is a systemic infection that sometimes is associated with cardiac manifestations. The diagnosis of Tropheryma whipplei endocarditis is still the result of chance because there are no diagnostic criteria and clinical signs are often those of cardiac disease rather than infection.
  
  
  METHODS
  Culture-negative endocarditis was suspected in a non-febrile 77-year-old French woman from North France with a history of a graft replacement 4 years prior. Positron emission tomography revealed intense fluorodeoxyglucose uptake around the metal ring of the aortic graft. The valve was replaced, and T. whipplei was detected in a valve sample by molecular assays. Immunohistochemical staining of the valve for T. whipplei was also positive.
  
  
  CONCLUSIONS
  The localization of infectious foci by positron emission tomography and systematically testing valve specimens for T. whipplei are promising for diagnosing Whipple's disease.
authors.affiliation: URMITE CNRS-IRD 198 UMR 6236, Aix Marseille Université, Faculté de Médecine et de Pharmacie, 27 Bd Jean Moulin, 13385, Marseille, France. SARAH-LYNE.JOS@ap-hm.fr.
authors.forename: Sarah-Lyne
authors.initials: SL
authors.lastname: Jos
authors.affiliation: URMITE CNRS-IRD 198 UMR 6236, Aix Marseille Université, Faculté de Médecine et de Pharmacie, 27 Bd Jean Moulin, 13385, Marseille, France. angelotasmanos@msn.com.
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Angelakis
authors.affiliation: INSERM, ERI-12 (EA 4292), University of Picardie, Department of Cardiac Surgery, University Hospital Amiens, Avenue René Laënnec - Salouël, 80054, Amiens, France. Caus.Thierry@chu-amiens.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Caus
authors.affiliation: URMITE CNRS-IRD 198 UMR 6236, Aix Marseille Université, Faculté de Médecine et de Pharmacie, 27 Bd Jean Moulin, 13385, Marseille, France. didier.raoult@gmail.com.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000382:microbiology / Q000473:pathology; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007150:Immunohistochemistry; D049268:Positron-Emission Tomography; D054851:Tropheryma / Q000502:physiology; D008061:Whipple Disease / Q000000981:diagnostic imaging*
chemical_list: D019788:Fluorodeoxyglucose F18