Whipples Disease
Description
An infection of the intestinal tract caused by the bacteria Tropheryma whipplei. The infection can spread to other parts of the body if not treated appropriately. Not everyone exposed to the bacteria becomes sick. Some researchers believe a defect in the immune system make some patients susceptible. It is a very uncommon disease, but can be fatal if untreated. This disorder is more common in men and most often seen after 40.
Symptoms
Diarrhea, abdominal pain, weight loss, fatigue, swollen joints, weakness, low red blood cell count (anemia), enlarged spleen, heart murmur, problems walking, seizures, confusion, excess fat in stool (steatorrhea).
Tests
A history and physical exam will be done. An small camera is placed through the mouth into the stomach and into the small intestine (endoscopy) to obtain small samples (biopsy). The bacteria is identified in these samples. Other tests may be done to determine anemia or other effects of the disease.
- CBC
- Esophagogastroduodenoscopy (EGD)
Treatment
Treatment requires antibiotics and therapy may last 1-2 years. If only the intestines are involved a 2 week course of intravenous ceftriaoxne (Rocephin) followed by 1-2 years of oral sulfamethoxazole/trimethoprim (Bactrim, Septra) is generally used. More severe infections that involve the brain and/or spinal cord require more intensive treatment. Other medications may be needed to treat other symptoms such a seizures.
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