Highlights
- •Whipple's disease (WD) is rare but Tropheryma whipplei commonly infects humans.
- •Asymptomatic carriage of T. whipplei, mainly in feces, is observed.
- •Chronic infections include disseminated WD and localized infections, such as endocarditis.
- •T. whipplei is associated with acute infections: gastroenteritis, pneumonia, and bacteremia.
- •T. whipplei seems to be an opportunistic bacterium.
Summary
Since its identification, information concerning Tropheryma whipplei, the causative agent of Whipple's disease (WD), has increased. Although T. whipplei is commonly infecting humans, WD is rare. The bacterium is most likely transmitted
among humans via the oro-oral and the feco-oral routes. Infections result in chronic
conditions such as asymptomatic carriage, disseminated Whipple's disease, which is
usually preceded by arthralgias, and localized infections, such as endocarditis or
encephalitis. T. whipplei is associated with acute infections including gastroenteritis, pneumonia, and/or
bacteremia. Screening, based on the combined analyses of saliva and stool specimens
using specific quantitative PCR, is useful if WD is suspected. Doxycycline and hydroxychloroquine
for 12 months is the best treatment for WD; it should be followed by life-long treatment
with doxycycline, as potentially fatal relapses can occur. T. whipplei seems to be an opportunistic bacterium that causes chronic infections in susceptible
patients with as yet unknown predisposing factors.
Keywords
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Article info
Publication history
Published online: May 27, 2014
Accepted:
May 19,
2014
Identification
Copyright
© 2014 The British Infection Association. Published by Elsevier Inc. All rights reserved.
