<i>Tropheryma whipplei</i>
            Infection of an Acellular Porcine Heart Valve Bioprosthesis in a Patient Who Did Not Have Intestinal Whipple's Disease

Dreier, Jens; Szabados, Florian; Herbay, A. von; Kröger, T.; Kleesiek, Knut

doi:10.1128/jcm.42.10.4487-4493.2004

Cited by 34 publications

(14 citation statements)

References 31 publications

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“…Of these, 18 references described one or more cases of IE in patients with no evidence of intestinal involvement. No involvement other than the heart was detected in nine patients (3,5,8,10,14,19,22,23), and we were able to obtain minimal data for eight, as shown in Tables 1 and 2. We have added our own case to the tables.…”

Section: Case Reportmentioning

confidence: 80%

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Tropheryma whipplei Infective Endocarditis as the Only Manifestation of Whipple's Disease

et al. 2007

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Here we describe a case of infective endocarditis caused by Tropheryma whipplei in a patient with no other symptoms of Whipple's disease. The case was diagnosed using broad-range PCR and confirmed by specific PCRs. We review the cases of infective endocarditis presenting as the only manifestation of Whipple's disease reported in the literature. CASE REPORTA 51-year-old man was admitted to a hospital with a 1-month history of low-grade fever, dyspnea, and ankle edema. His medical history was unremarkable, with no previous heart valve damage. Physical examination revealed a temperature of 37.2°C and grade II/VI systolic and diastolic murmurs. Laboratory analysis revealed a high white blood count with left-side deviation. Electrocardiography showed that the patient was in sinus rhythm at 95 beats per minute. A transesophageal echocardiogram revealed two vegetations, one on the aortic valve, measuring 22 mm at the maximum point, and a smaller one on the anterior leaflet of the mitral valve.

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Section: Case Reportmentioning

confidence: 80%

“…There are two published cases involving bioprosthetic material (3,20), but in only one was IE the only apparent manifestation of Whipple's disease (3).…”

Section: Case Reportmentioning

confidence: 99%

Tropheryma whipplei Infective Endocarditis as the Only Manifestation of Whipple's Disease

et al. 2007

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“…The causative pathogens were identified with standard bloodculture methods or broad-range PCR of the gene for bacterial 16S ribosomal DNA, as described previously (27 ). Patients with immunosuppression, cardiogenic shock, or septic shock were excluded.…”

Section: Patients and Controlsmentioning

confidence: 99%

Lipopolysaccharide-Binding Protein: A New Biomarker for Infectious Endocarditis?

et al. 2009

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Background: Infectious endocarditis (IE) is a bacterial infection of the endocardium. Diagnosis is based on results obtained from echocardiography, blood cultures, and molecular genetic screening for bacteria and on data for inflammatory markers such as the leukocyte (WBC) count and the C-reactive protein (CRP) concentration. The aim of the present study was to evaluate lipopolysaccharide-binding protein (LBP) as a supportive biomarker for the diagnosis and therapeutic monitoring of IE. Methods: We measured LBP and CRP concentrations and WBC counts in 57 IE patients at hospital admission, 40 patients with noninfectious heart valve diseases (HVDs), and 55 healthy blood donors. The progression of these 3 markers and the influence of cardiac surgery on them were evaluated in 29 IE patients and 21 control patients. Results: Serum LBP concentrations were significantly higher in IE patients [mean (SD), 33.41 (32.10) mg/L] compared with HVD patients [6.67 (1.82) mg/L, P < 0.0001] and healthy control individuals [5.61 (1.20) mg/L]. The progression in the LBP concentration during therapy of IE patients correlated with the changes in the CRP concentration. The 2 markers were equally influenced by antibiotic treatment and surgical intervention. Conclusions: Serial LBP measurement may provide an effective and useful tool for evaluating the response to therapy in IE patients. We found a strong correlation between LBP and CRP concentrations; LBP has a tendency to increase earlier in cases of reinfection.

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“…Endocarditis may be encountered as part of intestinal or systemic disease and it may occur in the setting of blood culture negative endocarditis [19,20].…”

Section: Clinical Featuresmentioning

confidence: 99%

Whipple’s Disease: A Case Report and Review of Literature

Elkholy¹,

Khaled²,

Aziz³

et al. 2017

MOJCR

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Whipple's disease is a rare systemic disease. It is caused by a gram-positive infectious bacillus called Tropheryma whipplei (T. whipplei). The common presenting feature is malabsorption, but it can also affect multiple organs as heart, central nervous system (CNS), joints, skin, lungs and vascular system. Presentation can be highly variable but mainly the patients are complaining of weight loss, diarrhea, joint pain and arthritis, about 15% of patients do not develop these classic symptoms. Endoscopic picture usually shows pale yellow shaggy mucosa with erythematous eroded patches in the duodenum extending up to the jejunum. Definitive diagnosis is made mainly by endoscopic duodenal biopsies that show characteristic foamy macrophages in the lamina propria containing non-acid fast gram positive bacilli that stain red with Periodic acid-Schiff (PAS) stain. Immunohistochemical staining for antibodies against T. whipplei had been used to detect the organism in a variety of tissues. Polymerase chain reaction (PCR) of T. whipplei is considered a confirmatory test. We present a case of classic Whipple's disease with review of literature for better understanding of the presentation, methods of diagnosis and treatment of the disease.

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Tropheryma whipplei Infection of an Acellular Porcine Heart Valve Bioprosthesis in a Patient Who Did Not Have Intestinal Whipple's Disease

Cited by 34 publications

References 31 publications

Tropheryma whipplei Infective Endocarditis as the Only Manifestation of Whipple's Disease

Tropheryma whipplei Infective Endocarditis as the Only Manifestation of Whipple's Disease

Lipopolysaccharide-Binding Protein: A New Biomarker for Infectious Endocarditis?

Whipple’s Disease: A Case Report and Review of Literature

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