Whipple's Disease
Whipple's disease (intestinal lipodystrophy) is the result of a rare bacterial infection that damages the lining of the small intestine and may involve other organs of the body.
Whipple's disease affects mainly men aged 30 to 60. It is caused by an infection with the organism Tropheryma whippelii. The infection usually involves the small intestine but can affect other organs, such as the heart, lung, brain, joints, and eye.
Symptoms
Symptoms of Whipple's disease include diarrhea, inflamed and painful joints, fever, and skin darkening. Severe malabsorption results in weight loss along with fatigue and weakness caused by anemia. Other common symptoms are abdominal pain, cough, and pain when breathing caused by inflammation of the membrane layers covering the lungs (pleura). Fluid may collect in the space between the pleural layers (a condition called pleural effusion (see Section 4, Chapter 52)). The lymph nodes may become enlarged. People with Whipple's disease may develop heart murmurs. Confusion, memory loss, or uncontrolled eye movements indicate that the infection has spread to the brain. If left untreated, the disease is progressive and fatal.
Diagnosis and Treatment
A doctor can make the diagnosis of Whipple's disease when a biopsy (a microscopic examination of tissue) of the small intestine or of an enlarged lymph node demonstrates the bacteria.
Whipple's disease can be cured with antibiotics such as tetracycline, ampicillin, trimethoprim/sulfamethoxazole, or penicillin taken for 6 to 12 months. Symptoms subside rapidly. Despite initial response to antibiotics, however, the disease can recur.
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