Whipple's Endocarditis

West, Douglas; Hutcheon, SD; Kain, Renate; Reid, T. M. S.; Walton, S.; Buchan, K

doi:10.1177/014107680509800809

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…The published data reviewed here suggest that endocarditis due to T. whipplei occurs not infrequently without any of the classical features of Whipple’s disease. At least six out of 27 patients in the present series did not have any symptoms other than those attributable to endocarditis [26,27,29,31,33,42], and our four patients clinically had no gastrointestinal involvement, fitting the diagnosis of isolated T. whipplei endocarditis. In patient 4 of our series a systemic involvement could not be excluded; however, weight loss and night sweats were considered to be manifestations of his underlying cancer.…”

Section: Discussionsupporting

confidence: 55%

“…Together, these reviews, reports and analyses total at least 70 cases of endocarditis due to T. whipplei, originating from Northern America, Germany, France, Switzerland, The Netherlands and South Africa. Our review of the literature encompasses the period up to June 2009 and adds another 27 cases resulting in at least 97 cases of endocarditis due to T. whipplei; the additional reports include patients from the UK, the Czech Republic, Spain, Brazil, Denmark, the Antilles and Tunisia [6,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Patients 1, 3, 6, 11, 16 and 26 had no symptoms other than those attributable to endocarditis and, in four of them (patients 1, 3, 16 and 26), analyses of the intestinal biopsies were negative, leading to the diagnosis of isolated T. whipplei endocarditis (patient characteristics shown in Tables 3 and 4; for a detailed analysis, see Supporting Information, Data S2).…”

Section: Review Of the Literaturementioning

confidence: 99%

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Endocarditis due to Tropheryma whipplei: rapid detection, limited genetic diversity, and long-term clinical outcome in a local experience

Escher

Roth

Droz

et al. 2010

Clinical Microbiology and Infection

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The characteristic features of Whipple's disease include abdominal pain, diarrhoea, wasting, and arthralgias, with the causative agent, Tropheryma whipplei, being detected mainly in intestinal biopsies. PCR technology has led to the identification of T. whipplei in specimens from various other locations, including the central nervous system and the heart. T. whipplei is now recognized as one of the causes of culture-negative endocarditis, and endocarditis can be the only manifestation of the infection with T. whipplei. Although it is considered a rare disease, the true incidence of endocarditis due to T. whipplei is not clearly established. With the increasing use of molecular methods, it is likely that T. whipplei will be more frequently identified. Questions also remain about the genetic variability of T. whipplei strains, optimal diagnostic procedures and therapeutic options. In the present study, we provide clinical data on four new patients with documented endocarditis due to T. whipplei in the context of the available published literature. There was no clinical involvement of the gastrointestinal tract. Genetic analysis of the T. whipplei strains with DNA isolated from the excised heart valves revealed little to no genetic variability. In a selected case, we describe acridine orange staining for early detection of the disease, prompting early adaptation of the antibiotic therapy. We provide long-term follow-up data on the patients. In our hands, an initial 2-week course of intravenous antibiotics followed by cotrimoxazole for at least 1 year was a suitable treatment option for T. whipplei endocarditis.

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Section: Discussionsupporting

confidence: 55%

Section: Review Of the Literaturementioning

confidence: 99%

Endocarditis due to Tropheryma whipplei: rapid detection, limited genetic diversity, and long-term clinical outcome in a local experience

Escher

Roth

Droz

et al. 2010

Clinical Microbiology and Infection

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Whipple’s disease-associated infective endocarditis: a systematic review

Ioannou,

Kourtidis,

Mytilinis

et al. 2023

Infectious Diseases

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Tropheryma whipplei Endocarditis: Case Presentation and Review of the Literature

McGee

Brienesse

Chong

et al. 2018

Open Forum Infectious Diseases

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Whipple’s disease is a rare infective condition, classically presenting with gastrointestinal manifestations. It is increasingly recognized as an important cause of culture-negative endocarditis. We present a case of Whipple’s endocarditis presenting with heart failure. A literature review identified 44 publications documenting 169 patients with Whipple’s endocarditis. The average age was 57.1 years. There is a clear sex predominance, with 85% of cases being male. Presenting symptoms were primarily articular involvement (52%) and heart failure (41%). In the majority of cases, the diagnosis was made on examination of valvular tissue. Preexisting valvular abnormalities were reported in 21%. The aortic valve was most commonly involved, and multiple valves were involved in 64% and 23% of cases, respectively. Antibiotic therapy was widely varied and included a ceftriaxone, trimethoprim, and sulfamethoxazole combination. The average follow-up was 20 months, and mortality was approximately 24%. Physician awareness is paramount in the diagnosis and management of this rare condition.

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Whipple's Endocarditis

Abstract: The causal organism in Whipple's disease, a rare disorder with characteristic duodenal and jejunal changes, was first cultured in 2000. 1 Although cardiac involvement is common in Whipple's, it is seldom an isolated finding.

Cited by 5 publications

References 7 publications

Endocarditis due to Tropheryma whipplei: rapid detection, limited genetic diversity, and long-term clinical outcome in a local experience

Endocarditis due to Tropheryma whipplei: rapid detection, limited genetic diversity, and long-term clinical outcome in a local experience

Whipple’s disease-associated infective endocarditis: a systematic review

Tropheryma whipplei Endocarditis: Case Presentation and Review of the Literature

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