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==Whipple disease== | ==Whipple disease== | ||
===General=== | ===General=== | ||
==== | Etiology: | ||
*Infection - caused by ''Tropheryma whipplei''.<ref>{{cite journal |author=Liang Z, La Scola B, Raoult D |title=Monoclonal antibodies to immunodominant epitope of Tropheryma whipplei |journal=Clin. Diagn. Lab. Immunol. |volume=9 |issue=1 |pages=156?9 |year=2002 |month=January |pmid=11777846 |pmc=119894 |doi= |url=http://cvi.asm.org/cgi/pmidlookup?view=long&pmid=11777846}}</ref> | |||
Epidemiology: | |||
*Very rare. | *Very rare. | ||
*Classically middle aged men. | *Classically middle aged men. | ||
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Treatment: | Treatment: | ||
*Antibiotics - for months and months. | *Antibiotics - for months and months. | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref>{{cite journal | author=Bai J, Mazure R, Vazquez H, Niveloni S, Smecuol E, Pedreira S, Mauriño E | title=Whipple's disease | journal=Clin Gastroenterol Hepatol | volume=2 | issue=10 | pages=849?60 | year=2004 | pmid=15476147 | doi=10.1016/S1542-3565(04)00387-8}}</ref> | Features:<ref name=pmid15476147>{{cite journal | author=Bai J, Mazure R, Vazquez H, Niveloni S, Smecuol E, Pedreira S, Mauriño E | title=Whipple's disease | journal=Clin Gastroenterol Hepatol | volume=2 | issue=10 | pages=849?60 | year=2004 | pmid=15476147 | doi=10.1016/S1542-3565(04)00387-8}}</ref> | ||
*Infectious microorganism typically found in macrophages. | *Infectious microorganism typically found in macrophages. | ||
**Macrophages usually abundant - '''key feature''' that should raise Dx in DDx. | **Macrophages usually abundant - '''key feature''' that should raise Dx in DDx. | ||
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DDx: | DDx: | ||
*Mycobacterium avium intracellulare (MAI). | *Mycobacterium avium intracellulare (MAI). | ||
===Stains=== | |||
*PAS +ve organisms. | |||
*AFB stain -ve -- to r/o MAI. | |||
Image: | |||
*[http://www.biomedcentral.com/content/figures/1472-6823-6-3-2-l.jpg Whipple disease - PAS stain (biomedcentral.com)]. | |||
==Microvillous inclusion disease== | ==Microvillous inclusion disease== |
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