Tropheryma whipplei causes acute diseases, such as gastroenteritis, bacteremia, and pneumonia 1, as well as chronic whipple disease 2. Warnock dw ed, manual of clinical microbiology, 11th ed, vol 1. Duke criteria were ineffective for diagnosis before heart valve analysis. Epidemiologic implications of the first isolation and. Tropheryma whipplei is a bacterium widely known to be associated with whipple disease wd, which is characterized by various clinical signs such as diarrhea, weight loss, lymphadenopathy, and polyarthritis 1. Classic wd was characterized by positive periodic acidschiff performed on duodenal biopsy.
Pdf tropheryma whipplei is the bacterial agent of the wellknown and rare whipples disease, mainly observed among caucasians. Whipple disease may also present as a purely osteoarticular infection, at least initially, often aggravated by the immunosuppressive therapy prescribed for rheumatologic. Tropheryma whipplei and gastroenteritis until recently, t. Whipple disease is a chronic, systemic illness that in the majority of cases involves the small intestine and its lymphatic drainage. Our objective is to describe, based on our experience, the culture of t. Tropheryma whipplei in patients with pneumonia volume 16. The main clinical manifestations of whipples disease are weight loss, arthropathy, diarrhea and abdominal pain. Tropheryma whipplei also has a mutation in the dna gyrase, which relates to the fact that it is resistant to quinolone antibiotic. First described by george hoyt whipple in 1907 and commonly considered a gastrointestinal disorder, whipples disease primarily causes malabsorption but may affect any part of the body including the heart, brain, joints, skin, lungs and the eyes.
Acute infections caused by tropheryma whipplei archive ouverte. Whipples disease is a systemic disease that affects many organ systems, producing. A key issue is the possibility of growing hostdependent bacteria in cellfree conditions. Relatives of chronic whipples disease patients have a higher chance of carrying the bacterium 16. It was finally isolated in eukaryotic cells in the year 2000 and propagated in culture at thirtyseven degrees celsius, but was believed to resist culturing for a long time 3. Patients present with intestinal malabsorption, weight loss, diarrhea, abdominal pain, fever, anemia, lymphadenopathy, and arthralgias. Tropheryma whipplei, the agent of whipples disease, inhibits phagolysosome biogenesis to create a suitable niche for its survival and replication in macrophages. Tropheryma whipplei in patients with pneumonia ncbi nih. To understand the mechanism by which it subverts phagosome maturation, we used biochemical and cell biological approaches to purify and characterise the intracellular compartment. Tropheryma whipplei is known as the cause of whipples disease, but it is also an emerging pathogen, detected in stool, that causes various chronic localized infections without histological. Due to the wide variability of manifestations, clinical diagnosis is very difficult and is often made only years or even decades after the initial symptoms have. High prevalence of tropheryma whipplei in lao kindergarten. Because of its metabolic deficiencies, like the major energy producing system, which is the krebs or tca it must get the nutrients it needs from the environment, in this case, the stomach lining.
Value of tropheryma whipplei quantitative polymerase chain. Mar 23, 2018 whipple disease wd is an infection caused by the bacterium tropheryma whipplei tw. Tropheryma whipplei endocarditis pubmed central pmc. In the past decade, the responsible organism tropheryma whipplei has been cultivated, its genome sequenced and its antibiotic susceptibility defined. Tropheryma whipplei is the causative agent of classic whipples disease wd and other clinical entities, such as localized infection. Tropheryma whipplei, formerly called tropheryma whippelii, is a bacterium and the causative organism of whipples disease and, rarely, of endocarditis while t.
Tropheryma whipplei colonization in hivinfected individuals. Unique genotypes were associated with this bacterium. Tropheryma whipplei is a bacterium widely known to be associated with whipple disease. The case i shows how previous symptoms can contribute to the diagnosis of this illness, and ii elucidates current recommended diagnostic and therapeutic approaches to whipples disease. Empirical approaches have guided the development of bacterial cultures. The name tropheryma whippelii was proposed for this bacterium. Tropheryma whipplei, molecular detection, pcr, blood mayo. Shotgun and assembly data from this project are available from our ftp site. The culture of tropheryma whipplei, the bacterium responsible for whipples disease, has been established only recently. Furthermore, clinical features such as blood culturenegative endocarditis and neurologic lesions have been reported 2. Tropheryma whipplei is indeed a pathogen that causes disease in human beings.
Tropheryma whipplei was detected in preliminary studies in faeces of young children with diarrhoea and also in faeces of asymptomatic persons, not only in europe but also in africa. In the absence of duodenal histologic involvement, localized infections were defined by specific positive t whipplei polymerase chain reaction pcr results obtained using samples of other tissues and body. The diagnosis of tropheryma whipplei infection should not rely solely upon the result of a pcr assay. A positive result indicates the presence of tropheryma whipplei dna a negative result indicates the absence of detectable t whipplei dna, but does not negate the presence of the organism and may occur due to inhibition of pcr, sequence variability underlying primers or probes, or the presence of t whipplei dna in quantities less than the limit of detection of the assay. Number of reported cases of tropheryma whipplei endocarditis per 1 million inhabitants in each area of france over 10 years. From december 2009 to january 20, rectal swabs collected from 3796 children in the. Tropheryma whippelii whipples disease infectious disease.
This not very wellunderstood pathogen is responsible for causing whipple disease. Whipples disease is a systemic disease that may affect almost any organ system of the body, but in most cases, it involves the small intestine. Incidence and prevalence of classic whipples disease. Transesophageal echocardiography tee showed a vegetation on noncoronary cusp of the aortic valve. Tropheryma whipplei whipples dna, qualitative, real. Tropheryma whipplei aortic valve endocarditis, cured without. Environmental studies of the possible sources of t whipplei eg, dust, specimens from. We have determined the genome sequence of tropheryma whipplei. In this study, the link between this bacterium and the presence of acute diarrhoea was evaluated in a large group of children. Mostly the diagnosis is made by histologic examination of resected heart valve tissue.
Progressive dementia associated with ataxia or obesity in. Tropheryma whipplei, formerly called tropheryma whippelii,1 is a bacterium and the causative organism of whipples disease2 and, rarely, of endocarditis. Clinical findings may include malabsorption, chronic diarrhea, abdominal pain, arthralgia, fever, and central nervous system symptoms. Tropheryma whipplei associated with diarrhoea in young. Tropheryma whipplei whipples dna, qualitative, realtime pcr tropheryma whipplei whipples disease dna, pcr is a highly sensitive and specific method to detect the presence of tropheryma whipplei dna in clinical specimens. Western blotting was performed for samples from children with diarrhea who had positive or negative results for t. Whipples disease is a rare, systemic infectious disease caused by the bacterium tropheryma whipplei. Tropheryma whipplei in children with gastroenteritis volume. Oct 30, 2012 culturenegative endocarditis due to tropheryma whipplei is a rare disease. Nov 18, 2015 tropheryma whipplei infection should be considered in patients with suspected infective endocarditis with negative blood cultures. Tropheryma whipplei is the causative bacterium of classic whipples disease, a chronic and rare infectious.
Lien externe modifier modifier le code sur les autres projets wikimedia. The disease primarily affects middleaged individuals, with a peak incidence in the third and fourth decades. The sequence has been submitted to emblgenbank with the accession number bx072543. T whipplei is frequently detected in stool and saliva samples from patients with whipples disease and, to a small degree, in asymptomatic carriers roughly 24%. Now, this appearance is nonspecific the main differentials are xanthelasma macrophages filled with fat and atypical mycobacterial infection macrophages filled with mycobacterium avium complex bacteria, both of which are more common than whipples disease. Tropheryma whipplei infection whipple disease in the usa. Research tropheryma whipplei in children with gastroenteritis. Tropheryma whipplei infection and whipples disease.
Tropheryma whipplei endocarditis differs from classic whipple disease, which primarily affects the gastrointestinal system. Tropheryma whipplei an overview sciencedirect topics. Specimens were analyzed mostly by molecular and histologic techniques. Tropheryma whipplei, which causes whipple disease, has been detected in 4% of fecal samples from the general adult population of france. The availability of sequenced genomes now provides opportunities to define culture media for growth of fastidious pathogens with computer modelling of metabolic networks. This disease is destructive to many of the bodies systems.
Summary background the classical form of whipples disease wd, clinically characterised by arthropathy, diarrhoea and weight loss, is rare. However, endocarditis is rare and is not usually the initial presentation of the disease. High prevalence of tropheryma whipplei in lao kindergarten children plos neglected tropical diseases, feb 2015 alpha kabinet keita, audrey dubotperes, koukeo phommasone, bountoy sibounheuang, manivanh vongsouvath, mayfong mayxay, didier raoult, paul n. A positive result should be considered in conjunction with clinical presentation and additional established clinical tests. Nov 01, 20 tropheryma whipplei endocarditis differs from classic whipple disease, which primarily affects the gastrointestinal system. Tropheryma whipplei, the agent of whipples disease, affects. From whipple disease to tropheryma whipplei infection. Tropheryma whipplei is the causal agent of whipples disease a systemic chronic infection affecting predominantly caucasian middleaged men and involving multiple organ systems. Our patient underwent aortic valve replacement after 4 weeks of antibiotic therapy with persistently negative blood culture results. Tropheryma whipplei pcr feedback i want to provide feedback regarding select test content or test information pricing and availability general usability of test directory look and feel of test directory request a new feature in test directory. Cases of tw infection diagnosed from 1995 to 2010 were identified in three us referral centers and from 1995 to 2015 in one.
Western blotting was performed for samples from children with diarrhea who had positive or negative results. In this case report, we described a patient with a classical whipples disease. Clinical manifestations, treatment, and diagnosis of tropheryma. To report on the demographics, clinical manifestations, diagnostic findings, treatment, and outcomes of tw infection. Data from this series and the literature 2224 were included. Whipples disease symptoms and diagnosis see online here whipples disease is a rare infection a. Tropheryma whipplei, which causes whipple disease, is found in human feces and may cause gastroenteritis. These represent macrophages filled with tropheryma whipplei. For faster navigation, this iframe is preloading the wikiwand page for tropheryma whipplei. Whipple disease celiac disease center columbia university. Tropheryma whipplei is the etiologic pathogenic agent of whipple disease wd, characterized by various clinical signs, such as diarrhea, weight loss. Tropheryma whipplei in fecal samples from children, senegal.
Jun 15, 2011 tropheryma whipplei, the agent of whipples disease, causes localised infections in the absence of histological digestive involvement. Tropheryma whipplei endocarditis is a cause of blood culturenegative endocarditis, relatively common in white men older than 50 years, with unexplained arthralgias. Pdf whipples disease and tropheryma whippelii researchgate. Polymerase chain reaction assay for the diagnosis of whipple disease. Genomebased design of a cellfree culture medium for. Text is available under the creative commons attributionsharealike license. The cause is now known to be tropheryma whipplei from the greek trophe, nourishment, and eryma, barrier, in reference to the nutrient malabsorption characteristic of the disease, a discovery made upon application of a new technique for identifying microbes based upon the dna sequence encoding their 16s ribosomal rna. To the best of our knowledge, this is the first reported case of a patient with tropheryma whipplei tricuspid endocarditis without any other valve. The causative bacterium tropheryma whipplei has only recently been successfully cultivated 6, 7. We first diagnosed a patient presenting dementia and obesity whose brain biopsy and cerebrospinal fluid specimens contained t. The sequenced tropheryma whipplei genome was analysed to. It causes intestinal malabsorption that leads to cachexia 3. May 07, 2009 occasionally, other sites of involvement have been documented, including isolated neurological disease, changes in the eyes and culturenegative endocarditis.
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