Tropheryma whipplei (Whipple's disease)

[European Heart J 2009;30:2369-2413.]

Clinical

- Peripheral manifestations may include: polyarthralgias, chronic diarrhea, weight loss, abdominal pain, neurologic symptoms.
- Almost always requires valve surgery.

Diagnosis

• Culture, immunohistology and PCR of surgical material

- Optimal duration of therapy unknown. To detect relapse/recolonization; check for presence of T. whipplei in saliva, feces, and blood:

• at 2 months after end of treatment, then

• every 6 months for 2 years

• yearly thereafter + echocardiography yearly.