Whipple's disease

Whipple's disease is a rare infectious disease that is classically in the duodenum.

General

Etiology:

• Infection - caused by Tropheryma whipplei a rod-shaped organisms.

Epidemiology:

• Very rare.
• Classically middle aged men.

Clinical

• Malabsorption (diarrhea), arthritis + others.
  • Symptoms are non-specific.

Treatment:

• Antibiotics - for months and months.

Microscopic

Features:

• Infectious microorganism typically found in macrophages.
  • Macrophages usually abundant - key feature that should raise Dx in DDx.
  • Organisms periodic acid-Schiff (PAS) positive.

DDx:

• Mycobacterium avium complex (MAC).

Images

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  Whipple disease - intermed. mag. (WC)

• 

  Whipple disease - high mag. (WC)

• 

  Whipple disease - poor quality - low mag. (WC)

Stains

• PAS +ve organisms.
• AFB stain -ve -- to r/o MAI.

Image:

• Whipple disease - PAS stain (biomedcentral.com).

See also

• Duodenum.