Whipple's

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T. whipplei

Presentation

  • Malabsoprtive diarrhea
  • Protein-losing enteropathy
  • Weight loss
  • Migratory arthritis (non-deforming)
  • Lymphadenopathy
  • Low grade fever
  • CNS
  • Cardiac

Diagnosis

  • Small intestinal biopsy (PAS + macrophages, non-acid fasting gram + bacilli)
  • PCR

Differential diagnosis

  • Celiac (anti-endomysial, anti-transglutaminase antibodies, blunting of villi)
  • Reactive arthritis (conjunctivitis, urethritis)
  • HIV + MAC (acid fast bacilli)