Current insights in Whipple’s disease

Flemmer, Mark; Flenner, Ronald W.

doi:10.1007/s11938-003-0028-3

Cited by 4 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 16 , 21 ] Patients should be followed for at least 10 years, as many develop late recurrences that can severely injure the CNS. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

“…To clear T. whippelii from the CNS, patients need primary treatment for 2 weeks with antibiotics that attain high CSF levels (e.g., ceftriaxone or penicillin G), followed by oral cotrimoxazole for 12 months. [16,21] Patients should be followed for at least 10 years, as many develop late recurrences that can severely injure the CNS. [21] Since CNS relapses carry a poor prognosis, antibiotics should not be reduced or discontinued.…”

Section: Discussionmentioning

confidence: 99%

“…[16,21] Patients should be followed for at least 10 years, as many develop late recurrences that can severely injure the CNS. [21] Since CNS relapses carry a poor prognosis, antibiotics should not be reduced or discontinued. ey should be prescribed at least for 1 year to prevent relapses.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Isolated central nervous system Whipple disease

Barbero-Aznarez¹,

Pérez‐Tanoira

Aguirre-Mollehuanca

et al. 2022

Surgical Neurology International

View full text Add to dashboard Cite

Background: Whipple disease (WD) is an infection caused by Tropheryma whipplei, which might present in three different forms: classical, localized, and isolated in the central nervous system (CNS). Methods: We report the result of a systematic review of the literature on WD unusually presenting with exclusively neurological symptoms, including two previously unpublished cases. A description of two cases with isolated CNS WD was performed, as well as a literature search in Cochrane, Scielo, and PubMed. Results: Two male adult patients presented with exclusively neurological symptomatology. Both magnetic resonance imaging (MRI) showed an intracranial mass suggestive of brain tumor. The histopathological examination was consistent with WD, with no systemic involvement. In the review of the literature, 35 cases of isolated CNS WD were retrieved. The median age at diagnosis was 43.5 (IQR 31.5–51.5). In 13 patients, the MRI showed a brain mass consistent with a brain tumor. The most common finding in the biopsy was the periodic-acid Schiff-stained foamy macrophages. Only five cases presented the pathognomonic sign of oculomasticatory myorhythmia. Thirteen cases had an adverse outcome that resulted in death during follow-up, whereas another 13 improved. The other nine patients remained stable or presented moderate improvement. Conclusion: Isolated CNS WD is a rare disease that should be considered among the differential diagnosis of CNS mass lesions. Brain biopsy is necessary to establish the diagnosis. It is stressed in the literature that an extended antibiotic course is required to prevent relapses and to control the disease.

show abstract

“…[ 16 , 21 ] Patients should be followed for at least 10 years, as many develop late recurrences that can severely injure the CNS. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated central nervous system Whipple disease

Barbero-Aznarez¹,

Pérez‐Tanoira

Aguirre-Mollehuanca

et al. 2022

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

Prosopagnosia as the Presenting Symptom of Whipple Disease

Tábuas‐Pereira

Vicente²,

Coelho³

et al. 2016

Cognitive and Behavioral Neurology

View full text Add to dashboard Cite

Whipple disease is a rare, chronic multisystem infectious disease. The central nervous system (CNS) is secondarily involved in 43% of patients; 5% of patients have isolated or primary CNS involvement. The most frequent CNS symptoms are cognitive changes. Prosopagnosia is an inability to recognize familiar faces, in a person who does not have vision impairments or cognitive alterations. This relatively rare condition is usually related to vascular, traumatic, degenerative, or infectious lesions. We report a 54-year-old woman who presented subacutely with fever, headache, and seizures that led to a diagnosis of infectious meningoencephalitis. She improved temporarily on broad-spectrum antibiotics, but then developed a chronically evolving cognitive impairment with associative prosopagnosia as the major complaint. She had a history of sporadic abdominal pain and mild sacroiliac arthralgia. After a negative duodenal biopsy, we confirmed primary CNS Whipple disease by polymerase chain reaction and brain biopsy. We treated the patient with ceftriaxone for 15 days and then co-trimoxazole for 2 years. At 8-year follow-up, she had no further impairments, but continuing prosopagnosia. To our knowledge, this is the first description of isolated prosopagnosia in a patient with primary CNS Whipple disease. Because CNS Whipple disease can lead to serious, irreversible lesions if not promptly treated, clinicians must suspect the diagnosis, treat with long-term antibiotics, and follow patients carefully to prevent recurrence.

show abstract

Enfermedad de Whipple y sistema nervioso central

Bermejo

Burgos

2006

Medicina Clínica

View full text Add to dashboard Cite

Current insights in Whipple’s disease

Cited by 4 publications

References 9 publications

Isolated central nervous system Whipple disease

Isolated central nervous system Whipple disease

Prosopagnosia as the Presenting Symptom of Whipple Disease

Enfermedad de Whipple y sistema nervioso central

Contact Info

Product

Resources

About