Misdiagnosing Whipple's disease in the young.
Whipple's disease is considered an infection of middle-aged white men of European ancestry. Cases are rare and disproportionately associated with occupational exposure to soil or animals. We report the case of a man aged 22 years with no risk factors, erroneously diagnosed with, and treated for, toxoplasmosis on the basis of consistent lymph node histology. The correct diagnosis was delayed by the dramatic symptomatic improvement resulting from this therapy. Whipple's disease should be considered in cases of granulomatous lymphadenopathy of unknown cause, even if the age of the patient does not fit the classic presentation of the disease.
Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
Danai
http://orcid.org/0000-0003-1629-6937
D
Papakonstantinou
Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
Michael J
MJ
Riste
Histopathology Department, Heart of England NHS Foundation Trust, Birmingham, UK.
Gerald
G
Langman
Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK.
Ed
E
Moran
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004386:Duodenum / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D014123:Toxoplasmosis / Q000175:diagnosis; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D008061:Whipple Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination