title: Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections.
abstract: Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection withTropheryma whipplei, a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity. The development of molecular techniques has resulted in more convenient methods for detectingT. whippleiinfections, and this has greatly improved the diagnosis of this often missed infection. In addition, the molecular detection ofT. whippleihas resulted in an increase in knowledge about its pathogenicity, and this review gives an overview of the new insights in epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment ofTropheryma whippleiinfections.
authors.affiliation: Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Ruben A V
authors.initials: RA
authors.lastname: Dolmans
authors.affiliation: Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: C H Edwin
authors.initials: CH
authors.lastname: Boel
authors.affiliation: Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Miangela M
authors.initials: MM
authors.lastname: Lacle
authors.affiliation: Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands h.kusters@umcutrecht.nl.
authors.forename: Johannes G
authors.initials: JG
authors.lastname: Kusters
mesh_terms: D000900:Anti-Bacterial Agents; D006801:Humans; D054851:Tropheryma / Q000502:physiology; D008061:Whipple Disease / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents
keywords: PCR; Tropheryma whipplei; Whipple's disease; antibiotics; clinical manifestations; histopathology; therapy