Tropheryma whipplei

Abstract

Tropheryma whipplei is the agent of classical Whipple disease, an infection originally described by the American pathologist George Hoyt Whipple in 1907 as intestinal lipodystrophy. Reasons are the rarity of the disease, the diversity and nonspecificity of symptoms, the fastidious nature of the pathogen, and the lack of serological tests. Data from two sequenced T. whipplei genomes reveal a small genome lacking key biosynthetic pathways. Whipple disease is a rare condition, with an estimated annual incidence of 1 case per 100,000 to 1,000,000. In classical Whipple disease, infection with T. whipplei probably occurs years before clinical manifestations point to the diagnosis. T. whipplei was detected in urine sediments by nucleic acid amplification testing in 9 of 12 patients and 10 of 13 patients with classical Whipple disease and in one patient with isolated endocarditis, but not in control persons, including healthy carriers.