Publications
| Title | Abstract | Year Filter | PMID(sorted ascending) Filter |
|---|
| [valvular locations in whipple's disease: report of two cases and review of the literature]. | whipple's disease is a consequence of an infection due to a bacteria called tropheryma whippelii. endocarditis is frequently described in post mortem studies on this disease but the diagnosis in living patients is uncommon. | 2001 | 11725719 |
| detection of a new 16s-23s rrna spacer sequence variant (type 7) of tropheryma whippelii in a patient with prosthetic aortic valve endocarditis. | 2001 | 11757986 | |
| primary diagnosis of whipple disease manifesting as lymphadenopathy: use of polymerase chain reaction for detection of tropheryma whippelii. | whipple disease is a rare, chronic multisystem disease associated with the recently characterized organism tropheryma whippelii. extraintestinal manifestation involving the central nervous system, heart, and joints occasionally occurs. involvement of the abdominal lymph nodes, especially the mesenteric and periaortic nodes, is not uncommon. however, peripheral lymphadenopathy as the sole clinical manifestation of whipple disease is rare. we describe 2 patients with whipple disease whose initial ... | 2001 | 11764080 |
| tropheryma whippelii and the (re)emergence of an old disease. | 2001 | 11764731 | |
| [clinical case of the month. whipple's disease: inaugural psychiatric symptoms]. | first considered to be a metabolic illness of the gastro-intestinal tract, whipple's disease has progressively been recognized as a systemic bacterial disorder due to tropheryma whippelii and responding to antibiotics. neurological symptoms occur in 10 to 20% of cases either initially or during the disease course. involvement of the central nervous system alone is rare. modern molecular biology methods, i.e. pcr amplification of 16s rrna can be applied to accessible biological fluids and/or tiss ... | 2001 | 11765576 |
| monoclonal antibodies to immunodominant epitope of tropheryma whipplei. | recent isolation of tropheryma whipplei (formerly trophyrema whippelii), the agent of whipple's disease, from the cardiac valve of a patient with whipple's disease endocarditis now allows the detection of reactive epitopes that could be used in a serological assay. in order to propose an enzyme-linked immunosorbent assay (elisa) that uses recombinant t. whipplei antigen, we first determined by western blotting of human, mouse, and rabbit antisera that the common immunodominant epitope is an 84-k ... | 2002 | 11777846 |
| survival of tropheryma whipplei, the agent of whipple's disease, requires phagosome acidification. | tropheryma whipplei was established as the agent of whipple's disease in 2000, but the mechanisms by which it survives within host cells are still unknown. we show here that t. whipplei survives within hela cells by controlling the biogenesis of its phagosome. indeed, t. whipplei colocalized with lysosome-associated membrane protein 1, a membrane marker of late endosomal and lysosomal compartments, but not with cathepsin d, a lysosomal hydrolase. this defect in phagosome maturation is specific t ... | 2002 | 11854238 |
| quantitative detection of tropheryma whipplei dna by real-time pcr. | 2002 | 11880458 | |
| the diagnosis and treatment of whipple's disease. | whipple's disease is a rare, chronic, and systemic infectious disease caused by the ubiquitously occurring bacterium tropheryma whippelii. for two reasons, the disease represents a good example for documenting the input of modern molecular-based techniques into pathogenetic, diagnostic, and therapeutic concepts in clinical medicine. first, the unidentified and uncultivable causative organism has been characterized by novel molecular-genetic techniques. second, in contrast to other chronic inflam ... | 2001 | 11892086 |
| molecular techniques in whipple's disease. | whipple's disease is a systemic infection, caused by the bacterium tropheryma whipplei, with protean clinical manifestations characterized by fever, weight loss, diarrhea, polyarthritis, skin hyperpigmentation and adenopathy. for a long time, due to the inability to culture the causative organism, diagnosis was based on histologic examination of infected tissues, usually duodenal biopsies, which revealed diastase-resistant periodic acid-schiff-positive staining. now, pcr of various tissues or fl ... | 2001 | 11901835 |
| polymerase chain reaction testing for tropheryma whippelii in unexplained isolated cases of arthritis. | 2002 | 11954000 | |
| whipple's disease. | whipple's disease is a chronic systemic bacterial infection that predominantly affects middle-aged men. antimicrobial therapy is curative. the causative agent has been identified as tropheryma whippelii. a pcr-based diagnostic test is now available and is particularly useful in patients with early-stage or atypical disease. the test can detect bacterial nucleic acids in tissues and body fluids, including joint fluid. studies using this test found no evidence that t. whippelii may be a common cau ... | 2002 | 12027303 |
| detection of tropheryma whipplei dna in feces by pcr using a target capture method. | whipple's disease is a rare multisystemic bacterial infection with variable clinical manifestations. for decades, the laboratory diagnosis was based on the demonstration of periodic acid schiff-positive inclusions in macrophages of gastrointestinal biopsies. pcr has improved the diagnosis of whipple's disease due to its increased sensitivity compared to histopathological analysis. to avoid invasive procedures for taking specimens, we have investigated the possibility of detecting tropheryma whip ... | 2002 | 12089263 |
| whipple's disease: a granulomatous masquerader. | whipple's disease is a multisystemic infection that affects middle-aged white men. it typically presents with fever, polyarthritis, diarrhea, steatorrhea, and weight loss. many other systems can be involved, however, including the central nervous system, heart, lymphatics, lungs, bone marrow, and skin. recent work has demonstrated the causative organism to be a complex bacteria, tropheryma whipplei. the diagnosis is established most securely by periodic acid-schiff staining of foamy monocyte-mac ... | 2002 | 12092044 |
| sicca syndrome associated with tropheryma whipplei intestinal infection. | the case of a 61-year-old woman with whipple's disease-associated sicca complex is reported. tropheryma whipplei infection was diagnosed by histological and ultrastructural examination of the jejunal mucosa and sequence analysis of the bacterial 16s ribosomal dna. the role of vitamin a malabsorption in sicca complex secondary to whipple's disease is discussed. | 2002 | 12149393 |
| cerebral whipple's disease with a stroke-like presentation and cerebrovascular pathology. | although neurological symptoms are common in whipple's disease, patients rarely have a purely neurological presentation and involvement restricted to the central nervous system is uncommon. a 39 year old woman presented with a meningoencephalitic illness, which responded to penicillin. eleven months later she developed recurrent stroke-like episodes. patchy enhancing meningeal, cortical, and subcortical lesions thought to be vascular in origin developed within nine days of the onset of symptoms. ... | 2002 | 12185176 |
| immunohistological detection of tropheryma whipplei (whipple bacillus) in lymph nodes. | 2002 | 12361821 | |
| dysregulated peripheral and mucosal th1/th2 response in whipple's disease. | an impaired monocyte function and impaired interferon (ifn)-gamma production has been suggested as a possible pathogenetic factor in whipple's disease (wd) and as a cause for the delayed elimination of tropheryma whipplei in some patients. | 2002 | 12404221 |
| [neurological manifestations of whipple disease]. | whipple disease is an uncommon chronic bacterial infection due to tropheryma whipplei. clinical manifestations are protean (joint pain, fever, weight loss, abdominal pain, lymphadenopathies), and the diagnosis is often delayed. although previously considered a late manifestation of whipple disease, neurological involvement is now frequently the initial clinical manifestation and represents the greatest risk for long-term disability. all patients should be treated and monitored as if they had cen ... | 2002 | 12407308 |
| [whipple disease--a rare systemic disease]. | whipple's disease is a rare, without antibiotic treatment deadly systemic infectious disease caused by the ubiquitary gram positive bacterium tropheryma whipplei. the agent can be demonstrated by light and electron microscopy and by pcr in tissues and body fluids affected. men are affected more often than women. most patients lose weight, have diarrhea, abdominal pain and arthralgias. in 10-40% of cases involvement of the cns, often asymptomatic, is observed. pas-positive macrophages in the lami ... | 2002 | 12422773 |
| diagnosis of wihipple disease by immunohistochemical analysis: a sensitive and specific method for the detection of tropheryma whipplei (the whipple bacillus) in paraffin-embedded tissue. | whipple disease is a rare infection characterized clinically by diarrhea, fever, weight loss, arthralgia, malabsorption, and other systemic manifestations. the etiologic agent, tropheryma whipplei, has been cultured only rarely. by using a polyclonal rabbit antibody produced against a cultured strain of t whipplei, tissue sections from 18 patients with whipple disease were studied. specimens from patients with histologic mimics and other infections served as control specimens. immunostaining was ... | 2002 | 12428795 |
| neurologic presentation of whipple disease: report of 12 cases and review of the literature. | we report 12 cases of whipple disease in patients with prominent neurologic symptoms, along with 122 cases of whipple disease with nervous system involvement reported in the literature. we analyzed the clinical signs and results of additional examinations in 2 groups: the first group included patients with predominantly but not exclusively neurologic signs, and the second included patients with clinically isolated neurologic presentation of the disease. whipple disease is a multisystemic infecti ... | 2002 | 12441901 |
| [whipple's disease: progress in the diagnosis and review of the literature]. | whipple's disease is a rare, chronic, multisystemic disease characterized by the presence of fever, diarrhea, weight loss and malabsorption, preceded by arthritis. although whipple's disease almost always includes involvement of the small intestine and the presence of malabsorption, it commonly affects other organs, especially the heart, brain, eyes and joints. whipple's disease greately mimics other diseases and is caused by a cultivation-resistant bacterium. the disease is fatal unless patient ... | 2002 | 12515967 |
| [whipple's disease--a rare cause of neurological symptoms and disorders]. | whipple's disease is a chronic infection caused by gram-positive bacillus thropheryma whippelii picture with a wide range of clinical manifestation, not only systemic but also neurological. seronegative arthritis or arthralgia may be the only presenting symptom, predating by years gastrointestinal, and also pulmonary, cardiac, renal and neurological manifestations. the diagnosis can be established based on the characteristic histopathological features found in the affected organ (foamy macrophag ... | 2002 | 12523120 |
| whipple's disease. | whipple's disease, or intestinal lipodystrophy, is a systemic infectious disorder affecting mostly middle-aged white men. patients present with weight loss, arthralgia, diarrhoea, and abdominal pain. the disease is commonly diagnosed by small-bowel biopsy; the appearance of the sample is characterised by inclusions in the lamina propria staining with periodic-acid-schiff, which represent the causative bacteria. tropheryma whipplei has been classified as an actinomycete and has been propagated in ... | 2003 | 12547551 |
| molecular diagnosis of culture negative infective endocarditis: clinical validation in a group of surgically treated patients. | to assess the clinical validity of polymerase chain reaction (pcr) based molecular methods in the microbiological diagnosis of culture negative infective endocarditis in a group of surgically treated patients. | 2003 | 12591825 |
| sequencing and analysis of the genome of the whipple's disease bacterium tropheryma whipplei. | whipple's disease is a rare multisystem chronic infection, involving the intestinal tract as well as various other organs. the causative agent, tropheryma whipplei, is a gram-positive bacterium about which little is known. our aim was to investigate the biology of this organism by generating and analysing the complete dna sequence of its genome. | 2003 | 12606174 |
| whipple arthritis: diagnosis by molecular analysis of synovial fluid--current status of diagnosis and therapy. | whipple's disease (wd) is an uncommon polysystem infectious disease. in the present report, we describe a patient who presented with a chronic illness consistent with wd and an avascular necrosis of the right hip joint. wd and its proposed causative bacillus, tropheryma whippelii, was identified by molecular analysis (polymerase chain reaction) in bacterial dna extracted from the synovial fluid. the diagnosis was additionally confirmed by upper gastrointestinal endoscopy and a small bowel biopsy ... | 2003 | 12626799 |
| immunodetection of tropheryma whipplei in intestinal tissues from dr. whipple's 1907 patient. | 2003 | 12672878 | |
| prevalence of tropheryma whipplei dna in patients with various gastrointestinal diseases and in healthy controls. | little is known about the epidemiology of tropheryma whipplei and its prevalence in people without clinical signs of whipple's disease. | 2003 | 12682812 |
| marginal and subgingival plaque--a natural habitat of tropheryma whipplei? | dna of tropheryma whipplei, the etiologic agent of whipple's disease, has recently been detected in the saliva of healthy subjects. in this pilot study we searched for the habitat of t. whipplei within the oral cavity. | 2003 | 12682813 |
| can whipple's disease be transmitted by gastroscopes? | to determine whether disinfection protocols currently used for gastroscopes are effective against cultures of tropheryma whipplei. | 2003 | 12683510 |
| molecular evaluation of antibiotic susceptibility: tropheryma whipplei paradigm. | tropheryma whipplei, the agent of whipple's disease, grows fastidiously only in cell cultures without plaque production, and only three strains have been passaged. the formation of bacterial clumps in the supernatant precludes enumeration of viable bacteria and mic determination. we evaluated the bacteriostatic effects of fluoroquinolones against two t. whipplei isolates by measuring the inhibition of the dna copy number increase by real-time quantitative pcr. the analysis of the t. whipplei gen ... | 2003 | 12709337 |
| analysis of conserved non-rrna genes of tropheryma whipplei. | the causative agent of whipple's disease, tropheryma whipplei, is a slow-growing bacterium that remains poorly-understood. genetic characterization of this organism has relied heavily upon rrna sequence analysis. pending completion of a complete genome sequencing effort, we have characterized several conserved non-rrna genes from t. whipplei directly from infected tissue using broad-range pcr and a genome-walking strategy. our goals were to evaluate its phylogenetic relationships, and to find wa ... | 2003 | 12747404 |
| mucosal immune response to tropheryma whipplei. | whipple's disease is a rare infectious disease caused by the ubiquitously occurring tropheryma whipplei in predisposed persons. genetic or acquired defects in the mucosal and peripheral immune system become apparent as diminished th1 immune functions with decreased production of il-12 and ifn-gamma accompanied by an increased secretion of il-4. these defects may enable t. whipplei to survive and replicate. the recently established cultivation of the bacterium in hel cells and the isolation from ... | 2003 | 12755367 |
| arthritis associated with enteric infection. | reactive arthritis is classically seen following infection with enteric pathogens such as yersinia, salmonella, campylobacter and shigella. inflammatory arthritis has also been described following other enteric infection with organisms such as clostridium difficile, brucella and giardia. furthermore, arthritis is seen in whipple's disease, caused by the actinomycete tropheryma whippelii. this chapter reviews the current understanding of these conditions (with the exception of brucella, which is ... | 2003 | 12787523 |
| whipple's disease: immunospecific and quantitative immunohistochemical study of intestinal biopsy specimens. | whipple's disease may be diagnosed by periodic acid-schiff (pas) staining, electron microscopy, or polymerase chain reaction of intestinal biopsy specimens. the aim of this study was to evaluate the diagnostic value of immunohistochemistry and the quantification of infected cells in intestinal whipple's disease. a total of 29 duodenal biopsy specimens from 15 patients with untreated and treated whipple's disease were examined and compared with biopsy specimens from control patients with normal i ... | 2003 | 12827613 |
| tropheryma whippelii as a cause of afebrile culture-negative endocarditis: the evolving spectrum of whipple's disease. | with the advent of molecular diagnostics culture-negative endocarditis caused by the organism tropheryma whippelii is an increasingly described entity. we describe two patients with afebrile, culture-negative endocarditis caused by t. whippelii who had neither the gastrointestinal nor arthritic manifestations of whipple's disease. whipple's disease is a systemic illness caused by the organism tropheryma whippelii and is typically characterized by diarrhea, weight loss, and arthropathy [clin. mic ... | 2003 | 12860154 |
| cloning and sequencing an unknown gene of tropheryma whipplei and development of two lightcycler pcr assays. | whipple's disease is a rare infectious illness that can affect any organ system in the body. it is caused by tropheryma whipplei, a gram-positive rod-shaped bacterium with a high g + c content, classified within the actinobacteria. for decades, laboratory detection has been based on microscopy and the periodic acid-schiff (pas) staining of biopsies. recently, pcr has become a useful tool to detect t. whipplei dna in various clinical specimens. however, a positive pcr result does not confirm whip ... | 2003 | 12867093 |
| tropheryma whipplei twist: a human pathogenic actinobacteria with a reduced genome. | the human pathogen tropheryma whipplei is the only known reduced genome species (<1 mb) within the actinobacteria [high g+c gram-positive bacteria]. we present the sequence of the 927303-bp circular genome of t. whipplei twist strain, encoding 808 predicted protein-coding genes. specific genome features include deficiencies in amino acid metabolisms, the lack of clear thioredoxin and thioredoxin reductase homologs, and a mutation in dna gyrase predicting a resistance to quinolone antibiotics. mo ... | 2003 | 12902375 |
| culture of tropheryma whipplei from human samples: a 3-year experience (1999 to 2002). | the culture of tropheryma whipplei, the bacterium responsible for whipple's disease, has been established only recently. our objective is to describe, based on our experience, the culture of t. whipplei in hel cells detected by immunofluorescence staining. over 3 years, we received 18 samples for t. whipplei culture from 15 patients with whipple's disease. ten duodenal biopsy specimens from 10 patients with digestive symptoms were available. five cardiac valves and three blood samples from five ... | 2003 | 12904394 |
| [neurological complications of inflammatory intestinal diseases]. | a number of neurological symptoms have been described as complications of inflammatory bowel disorders such as coeliac disease, whipple's disease, crohn's disease and ulcerative colitis. the neurology of coeliac disease includes disorders of the central nervous system encompassing cerebellar ataxia, epilepsy, myoclonus, dementia and multifocal leukoencephalopathy. peripheral neuropathies, of axonal and demyelinating types, and myopathies have also been reported. the pathomechanisms are more rela ... | 2003 | 12910446 |
| genome-based design of a cell-free culture medium for tropheryma whipplei. | empirical approaches have guided the development of bacterial cultures. the availability of sequenced genomes now provides opportunities to define culture media for growth of fastidious pathogens with computer modelling of metabolic networks. a key issue is the possibility of growing host-dependent bacteria in cell-free conditions. the sequenced tropheryma whipplei genome was analysed to identify specific metabolic deficiencies. we used this information to design a comprehensive medium that allo ... | 2003 | 12927433 |
| whipple's disease. | whipple's disease is an infectious disease caused by a gram-positive bacterium, tropheryma whipplei. the first case was reported in 1907 by gh whipple. its classic symptoms are diarrhea and arthralgias, but symptoms can be various. cardiac or central nervous system involvement, not always associated with digestive symptoms, may also be observed. for a long time, diagnosis has been based on duodenal biopsy, which is positive using periodic acid-schiff staining. however, for patients without diges ... | 2003 | 12959718 |
| cultivation of tropheryma whipplei from cerebrospinal fluid. | whipple disease (wd) is a systemic disorder caused by the bacterium tropheryma whipplei. since the recognition of a bacterial etiology in 1961, many attempts have been made to cultivate this bacterium in vitro. it was eventually isolated, in 2000, from an infected heart valve, in coculture with human fibroblasts. here we report the isolation of 2 new strains of t. whipplei from cerebrospinal fluid (csf) of 2 patients with intestinal wd but no neurological signs or symptoms. one culture-positive ... | 2003 | 12964110 |
| whipple disease. | whipple disease is a rare disease caused by infection with the bacterium tropheryma whippelii. humans are the only known host for the infection. the signs of systemic infection include gastrointestinal problems, weight loss, and arthritis. signs of central nervous system infection include cognitive changes, supranuclear gaze palsy, altered level of consciousness, and movement disorders. the diagnosis is based on clinical findings as well as microscopic examination of biopsy specimens and, more r ... | 2003 | 14565900 |
| spondylodiscitis as the first manifestation of whipple's disease -a removal worker with chronic low back pain. | whipple's disease is a rare systemic infectious disease caused by the actinobacterium tropheryma whipplei. spondylodiscitis is an extremely rare manifestation of the infection and has previously been described in only three case reports. we present a 55-year-old man with persistent lumbago and signs of systemic illness, but without any gastrointestinal symptoms or arthralgia. the signal response in the lumbar spine in magnetic resonance tomography, both native and after intravenous gadolinium ad ... | 2003 | 14677024 |
| culture of tropheryma whippelii from the vitreous fluid of a patient presenting with unilateral uveitis. | 2003 | 14678933 | |
| use of genome selected repeated sequences increases the sensitivity of pcr detection of tropheryma whipplei. | the availability of the tropheryma whipplei genome offers the putative possibility of choosing logical dna targets. we applied a pcr assay (targeting repeated sequences of t. whipplei) to samples from patients with whipple's disease and to those from members of a control group. when compared to the results seen with regular pcr, the sensitivity of repeat pcr was significantly enhanced (p = 0.02) without alteration of its specificity. | 2004 | 14715790 |
| infective endocarditis. | despite improvements in health care, the incidence of infective endocarditis has not decreased over the past decades. this apparent paradox is explained by a progressive evolution in risk factors; while classic predisposing conditions such as rheumatic heart disease have been all but eradicated, new risk factors for infective endocarditis have emerged. these include intravenous drug use, sclerotic valve disease in elderly patients, use of prosthetic valves, and nosocomial disease. newly identifi ... | 2004 | 14726169 |
| antibiotic susceptibility of tropheryma whipplei in mrc5 cells. | whipple's disease is considered a rare chronic disease with a broad spectrum of clinical manifestations. several antibiotics have been used for the treatment of this disease, and the current reference treatment was determined empirically on the basis of only a few clinical observations. patients should be treated for months, and many relapse after antibiotic withdrawal. we report here the first extensive study on the susceptibilities of three reference strains of tropheryma whipplei to antibioti ... | 2004 | 14982759 |
| cerebral whipple's disease diagnosed using pcr: the first case reported from greece. | whipple's disease (wd) is a rare multisystemic bacterial infection, with variable clinical manifestations occasionally involving the central nervous system. as the cultivation of the etiologic agent, tropheryma whippelii, is difficult, a laboratory diagnosis is usually based on histological methods. in the last few years, molecular detection of the bacterial 16srrna genes by pcr, with 2 primer sets, has greatly contributed to the ability of clinicians to diagnose this disease. we present a cereb ... | 2003 | 15068393 |
| invasion of the central nervous system by intracellular bacteria. | infection of the central nervous system (cns) is a severe and frequently fatal event during the course of many diseases caused by microbes with predominantly intracellular life cycles. examples of these include the facultative intracellular bacteria listeria monocytogenes, mycobacterium tuberculosis, and brucella and salmonella spp. and obligate intracellular microbes of the rickettsiaceae family and tropheryma whipplei. unfortunately, the mechanisms used by intracellular bacterial pathogens to ... | 2004 | 15084504 |
| primary diagnosis of whipple's disease in bone marrow. | whipple's disease (wd) is a chronic systemic inflammatory disease of infectious origin caused by tropheryma whipplei (tw). abdominal pain and recurrent diarrhea are usually the main symptoms leading to the suspicion of a primary bowel disease. systemic manifestations can mimic hematologic disorders. a 49-year-old man presented with fever, weight loss, long-standing arthralgia, and diarrhea. a duodenal biopsy was unremarkable. bone marrow histology provided no evidence of a malignant hematologica ... | 2004 | 15116337 |
| a rare course of whipple's disease with atypical cardiac manifestation. | whipple's disease (wd) is a rare disorder caused by the gram-positive actinomycete tropheryma whippelii (1). an oral route of acquisition is presumed (2). wd is a chronic systemic infection morphologically characterized by foamy pas-positive macrophages. this case report depicts the diagnosis and clinical management of a woman who presented with atypical cardial manifestations of wd and died from severe cardiac impairment by tropheryma whippelii which was confirmed by polymerase chain reaction. ... | 2004 | 15153165 |
| whipple's disease with neurological manifestations: case report. | whipple's disease (wd) is an uncommon multisystem condition caused by the bacillus tropheryma whipplei. central nervous system involvement is a classical feature of the disease observed in 20 to 40% of the patients. we report the case of a 62 year old man with wd that developed neurological manifestations during its course, and discuss the most usual signs and symptoms focusing on recent diagnostic criteria and novel treatment regimens. | 2004 | 15235743 |
| refractory whipple's disease with anaemia: first lessons from capsule endoscopy. | whipple's disease is a chronic multisystem disorder caused by infection with the rod-shaped bacterium, tropheryma whippelii. we report the case of a 65-year-old woman with intestinal whipple's disease that had been refractory to monotherapy with a number of antibiotics over a 2-year period. the patient then presented with watery diarrhoea, cachexia (body mass index 18 kg/m (2)) and chronic anaemia (haemoglobin 7.6 g/dl). wireless capsule endoscopy showed that the disease affected the entire smal ... | 2004 | 15243893 |
| cardiac valves in patients with whipple endocarditis: microbiological, molecular, quantitative histologic, and immunohistochemical studies of 5 patients. | the pathological features of whipple endocarditis, which is caused by tropheryma whipplei, were histologically evaluated in cardiac valves from 5 patients. we used quantitative image analysis to compare the valvular fibrosis, calcifications, vegetations, inflammation, and vascularization due to whipple endocarditis with those due to non-whipple endocarditis and degenerative valves. we also studied the presence of t. whipplei in valves by immunohistochemical analysis, culture, and polymerase chai ... | 2004 | 15295699 |
| whipple disease confined to the central nervous system presenting as a solitary frontal tumor. case report. | whipple disease is a rare infection caused by the bacterium tropheryma whippelii. patients usually present with gastrointestinal symptoms or migratory arthralgias. although symptomatic central nervous system (cns) involvement frequently occurs, whipple disease confined to the cns is rare. the authors present the case of a 40-year-old man who was surgically treated for a symptomatic left frontal tumor that had the neuroimaging features of a low-grade glioma (lgg). a histopathological investigatio ... | 2004 | 15309928 |
| whipple's disease: the first japanese case diagnosed by electron microscopy and polymerase chain reaction. | a 52-year-old man presented with diarrhea and 20 kg weight loss in one year. enteroscopy showed diffuse yellow-white shaggy mucosa in the duodenum and jejunum. biopsies of the duodenal mucosa revealed massive infiltration within the lamina propria by foamy macrophages strongly positive for periodic acid-schiff stain. electron microscopy demonstrated numerous bacilli within macrophages of the lamina propria. tropheryma whipplei dna was detected by polymerase chain reaction. the definitive diagnos ... | 2004 | 15335181 |
| tropheryma whipplei infection of an acellular porcine heart valve bioprosthesis in a patient who did not have intestinal whipple's disease. | rare cases of culture-negative infective endocarditis are caused by tropheryma whipplei, the uncommon bacterium of whipple's disease. we evaluated an 80-year-old woman with valvular heart disease but without intestinal whipple's disease. the diagnosis of aortic valve xenograft culture-negative infection with t. whipplei was established by multiple molecular assays and by electron microscopy. first, a pcr with broad-range primers identified the complete 16s ribosomal dna of t. whipplei in biopros ... | 2004 | 15472298 |
| whipple's disease. | whipple's disease is a rare multisystemic infectious disorder affecting predominantly middle-aged men. clinical manifestations are very variable with a very long, insidious, prediagnostic course. weight loss, chronic diarrhea, arthralgias, and low-grade fever are characteristic features in most patients. although gastrointestinal compromise is very common, atypical clinical forms are being increasingly recognized. although a bacterial cause was strongly suggested for many years, the infectious a ... | 2004 | 15476147 |
| [endocarditis caused by tropheryma whippelii]. | cardiac involvement in whipple's discase is frequent. however, its clinical occurrence without gastrointestinal symptoms is rarely described. whipple's endocarditis occurs ollen in patients wilh native valves, without underlying, disease. it affects frequently more than one valve h, the same patient. its clhlical presentation is generally subacute or chronic. fever and congestive heart failure are fickle. histological findings on the valves suggest the diagnosis, that con be confirmed by pcr tec ... | 2004 | 15532776 |
| progress, problems, and perspectives in diagnosis and treatment of whipple's disease. | whipple's disease is a rare chronic infectious disorder first described in 1907 by g.h. whipple. the disorder is caused by the newly identified bacterium tropheryma whipplei and there is evidence that altered immune functions play a role in the manifestation of the disease. the organ systems mostly affected are the joints and the gut, and in the further course often also the heart, lung, brain, and eyes. the intestinal involvement occurs with abdominal pain and diarrhea, which leads to weight lo ... | 2004 | 15598084 |
| metagrowth: a new resource for the building of metabolic hypotheses in microbiology. | metagrowth is a new type of knowledge base developed to guide the experimental studies of culture conditions of obligate parasitic bacteria. we have gathered biological evidences giving possible clues to the development of the axenic (i.e. 'cell-free') growth of obligate parasites from various sources including published literature, genomic sequence information, metabolic databases and transporter databases. the database entries are composed of those evidences and specific hypotheses derived fro ... | 2005 | 15608207 |
| molecular genetic methods for the diagnosis of fastidious microorganisms. | technological innovations in the detection and identification of microorganisms using molecular techniques such as polymerase chain reaction (pcr) have ushered in a new era with respect to diagnostic microbiology. pcr using universal or specific primers followed by identification of amplified product, mainly by sequencing, has enabled the rapid identification of cultured or uncultured bacteria. thus, pcr may allow quick diagnosis of infections caused by fastidious pathogens for which culture cou ... | 2004 | 15638838 |
| molecular evaluation of antibiotic susceptibility of tropheryma whipplei in axenic medium. | whipple's disease is a rare multisystem chronic infection, involving the intestinal tract as well as various other organs. tropheryma whipplei is a slow-growing facultative intracellular bacterium that remains poorly understood. in vitro antibiotic susceptibility testing has previously been assessed in cells using a real-time quantitative pcr assay. in this study, we have evaluated the antibiotic susceptibility of three strains of t. whipplei grown in axenic medium using the same assay. | 2005 | 15650004 |
| deadly carousel or difficult interpretation of new diagnostic tools for whipple's disease: case report and review of the literature. | whipple's disease is a rare systemic disorder classically presenting with weight loss, arthralgias, and diarrhea, which was first described in 1907. the causative bacterium tropheryma whipplei, is a fastidious organism not growing on conventional media. before the introduction of polymerase chain reaction (pcr)-based methods, the diagnostic gold standard was histological detection of diastase-resistant periodic acid schiff (pas)-positive macrophages or electron microscopy. as in the present case ... | 2005 | 15750760 |
| [weight loss, renal insufficiency, aortal stenosis and arthralgias]. | the 68-year-old male patient complained of weight loss and -- since 15 years -- of arthralgias and had renal insufficiency and an aortic stenosis. despite the lack of intestinal symptoms, m. whipple could be diagnosed, being responsible for his symptoms and clinical signs. under antibiotic and supportive treatment the patient recovered uneventfully.whipple's disease, otherwise known as intestinal lipodystrophy, is a disease with various signs and symptoms. the principal signs are rheumatic compl ... | 2005 | 15772857 |
| cerebral whipple's disease as a cause of reversible dementia. | we describe a case of reversible dementia caused by tropheryma whippelii (tw). diagnosis was confirmed by a positive polymerase chain reaction for this pathogen both on serum and cerebrospinal fluid. specific antibiotic therapy resulted in distinct clinical and neuroradiological improvement. control polymerase chain reaction for t. whippelii on serum and cerebrospinal fluid was negative. | 2005 | 15823686 |
| immunosuppressive therapy in whipple's disease patients is associated with the appearance of gastrointestinal manifestations. | whipple's disease is a rare chronic disorder, which is caused by systemic infection with tropheryma whipplei. the first symptom of whipple's disease usually is a nondestructive polyarthritis resembling in many aspects seronegative rheumatoid arthritis. this polyarticular inflammatory arthropathy preceding the diagnosis of whipple's disease for several years frequently is treated with nonsteroidal antiinflammatory drugs (nsaids) and with immunosuppressive therapy. there is evidence that altered i ... | 2005 | 15842595 |
| blood culture-negative endocarditis in a reference center: etiologic diagnosis of 348 cases. | to identify the current etiologies of blood culture-negative infective endocarditis and to describe the epidemiologic, clinical, laboratory, and echocardiographic characteristics associated with each etiology, as well as with unexplained cases, we tested samples from 348 patients suspected of having blood culture-negative infective endocarditis in our diagnostic center, the french national reference center for rickettsial diseases, between 1983 and 2001. serology tests for coxiella burnettii, ba ... | 2005 | 15879906 |
| whipple disease: a case report and review of the literature. | whipple disease is a chronic, relapsing, and multisystem disease. it presents a diagnostic challenge for both clinicians and pathologists. recent advances in isolation and culture have identified the organism responsible for the disease to be a member of the order actinomycetes designated tropheryma whipplei. several immune system changes have been noted in patients with whipple disease, but whether these are primary or secondary is as yet undetermined. long-term antibiotic therapy is required, ... | 2005 | 15974820 |
| detection of tropheryma whipplei dna in clinical specimens by lightcycler real-time pcr. | a real-time pcr method using the lightcycler (roche applied science, indianapolis, in) was compared to a conventional pcr assay for the detection of tropheryma whipplei in 321 clinical specimens. the lightcycler method had sensitivity and specificity comparable to the conventional method but required considerably less labor and time (3 h versus 3 to 5 days). | 2005 | 16000494 |
| [whipple's disease. two new cases of an underdiagnosed disease]. | whipple's disease is a rare systemic infectious disease caused by the bacterium tropheryma whippelii. early diagnosis is essential. whipple's disease is potentially fatal but responds dramatically to antibiotic treatment. the diagnosis is confirmed by means of polymerase chain reaction (pcr) technology. this analysis may be useful for monitoring the efficacy of therapy. the recommended treatment al present is administration of cotrimoxazole twice daily for one year. when cns involvement occurs, ... | 2005 | 16001939 |
| a patient with cerebral whipple's disease and a stroke-like syndrome. | the central nervous system (cns) may be affected in up to 50% of patients with whipple's disease and this can occur even with little or no gastrointestinal involvement. we describe a 63-year-old patient in whom cns involvement with whipple's disease had the clinical and imaging features of a brain infarction. treatment with aspirin and ceftriaxone followed by trimethoprim-sulfamethoxazole resulted in a good neurological recovery and complete remission of the malabsorption syndrome. cerebral whip ... | 2005 | 16036516 |
| whipple's disease: multiple hospital admissions of a man with diarrhoea, fever and arthralgia. | whipple's disease is a rare chronic multi-systemic infectious disorder caused by the gram-positive bacillus, tropheryma whippelii. infection may involve any organ in the body, and most commonly affects white men in the fourth to sixth decades of life. the most common presenting symptoms are gastrointestinal and include abdominal pain, diarrhoea, anorexia and associated weight loss. however, the variability in presentation is considerable and some patients may present with intermittent low-grade ... | 2005 | 16038747 |
| an unusual case of insomnia associated with whipple encephalopathy: first case reported from greece. | whipple disease is a relapsing systemic illness caused by tropheryma whippelii. central nervous system involvement occurs in 5%-40% of all patients. hypothalamic manifestations occur in 31% of whipple encephalopathy, including polydipsia, hyperphagia, change in libido and insomnia. we report a case of a 48-year-old man with severe insomnia, depression, dementia, dysarthria, myoclonic movements of the limbs and ophthalmoplegia. the diagnosis of whipple encephalopathy was confirmed by pcr analysis ... | 2005 | 16086132 |
| exacerbation of whipple's disease associated with infliximab treatment. | a 34-year-old man with chronic inflammatory joint disease and recurrent fever over 6 years was diagnosed as having still's disease. treatment with corticosteroids and azathioprine was ineffective. therefore, infliximab/ methotrexate was started. the patient subsequently developed a wasting disease with rapid weight loss, erythema nodosum, diarrhoea, progressive lymph node enlargement, and a sigmoido-vesical fistula. histological analysis of several enlarged lymph nodes, the margins of the fistul ... | 2005 | 16095013 |
| [whipple's disease endocarditis: report of 5 cases and review of the literature]. | endocarditic lesions (infectious endocarditis) associated with whipple's disease are exceptional. we report five cases from the cardiovascular and pneumologic hospital louis pradel in lyon. | 2005 | 16146664 |
| il-16 is critical for tropheryma whipplei replication in whipple's disease. | whipple's disease (wd) is a rare systemic disease caused by tropheryma whipplei. we showed that t. whipplei was eliminated by human monocytes but replicated in monocyte-derived macrophages (mphi) by inducing an original activation program. two different host molecules were found to be key elements for this specific pattern. thioredoxin, through its overexpression in infected monocytes, was involved in bacterial killing because adding thioredoxin to infected mphi inhibited bacterial replication. ... | 2005 | 16177102 |
| [whipple's disease--a challenging diagnosis]. | whipple's disease is a rare multisystemic disease caused by gram-positive bacillus, tropheryma whippelii, family of actinobacterias and group of actinomycetes. because the disease is rare and has different forms of presentation the diagnosis comes frequently late. the authors present the case of a white man, 50 years old, admitted with a clinical picture characterized by weight loss, abdominal pain, ascites, diarrhea. he suffered of arthralgias for four years. the diagnosis was made by biopsy of ... | 2004 | 16197860 |
| whipple disease: intestinal infiltrating cells exhibit a transcriptional pattern of m2/alternatively activated macrophages. | whipple disease (wd) is a rare systemic disease caused by tropheryma whipplei and is characterized by the presence of foamy macrophages with periodic acid-schiff-positive inclusions in tissues such as lamina propria. for the first time, we report the gene-expression profile of macrophages in intestinal lesions from a patient with wd. microarray and real-time polymerase chain reaction revealed that genes encoding ccl18, cathepsins, scavenger receptor, interleukin-10, and lipid metabolites were up ... | 2005 | 16206080 |
| [whipple disease and central nervous system]. | whipple disease (wd) is a rare systemic infection caused by the bacteria tropheryma whipplei. slowly progressive dementia, supranuclear ophthalmoplegia, headache, myoclonus, hypothalamic dysfunction, oculomasticatory-skeletal myorythmia are characteristic manifestations when wd involves the central nervous system (cns). treatment of cerebral wd should be performed with antibiotics that reach the cns for at the least one-year. we alert for the early diagnosis of wd in patients with exclusively ne ... | 2005 | 16207456 |
| intervening sequence acquired by lateral gene transfer in tropheryma whipplei results in 23s rrna fragmentation. | completion of tropheryma whipplei genome sequencing may provide insights into the evolution of the molecular mechanisms underlying the pathogenicity of this microorganism. the first postgenomic application was the successful design of a comprehensive culture medium that allows axenic growth of this bacterium, which is particularly recalcitrant to cultivation. this achievement in turn permitted analysis of t. whipplei rna without contaminating eukaryotic nucleic acids. to obtain high-quality rna, ... | 2005 | 16269699 |
| [whipple disease, initially diagnosed as sarcoidosis]. | whipple disease is a multisystem infectious disease caused by tropheryma whipplei. we report a case in which an initial diagnosis of sarcoidosis was changed to whipple disease endocarditis. | 2005 | 16301965 |
| whipple's disease. description of a case and survey of the literature. | a case of whipple's disease (wd) personally observed is described. a 28-year-old male was admitted to hospital for evaluation of weakness, intermittent fever and weight loss arisen since a month. on clinical investigation, he complained of vomit and diarrhea since three months. he had neither familial and personal past history of gastrointestinal diseases, nor any other important diseases. he denied use of drugs. physical examination was negative. laboratory findings showed anemia, low blood lym ... | 2000 | 16498356 |
| decision analysis: an aid to the diagnosis of whipple's disease. | diagnosis of whipple's disease, a rare systemic infection affecting predominantly the small bowel, is based on the identification of the bacterium tropheryma whipplei. | 2006 | 16556186 |
| evolutionary constraints on codon and amino acid usage in two strains of human pathogenic actinobacteria tropheryma whipplei. | the factors governing codon and amino acid usages in the predicted protein-coding sequences of tropheryma whipplei tw08/27 and twist genomes have been analyzed. multivariate analysis identifies the replicational-transcriptional selection coupled with dna strand-specific asymmetric mutational bias as a major driving force behind the significant interstrand variations in synonymous codon usage patterns in t. whipplei genes, while a residual intrastrand synonymous codon bias is imparted by a select ... | 2006 | 16557339 |
| identification of candidate antigen in whipple's disease using a serological proteomic approach. | whipple's disease (wd) is a chronic multisystemic infection, caused by tropheryma whipplei, a gram-positive rod. recently, a reliable method has been developed for cultivating t. whipplei in vitro. this together with the availability of complete genome sequence of t. whipplei prompted us to initiate proteome analysis of t. whipplei. the objective of the present study was to identify candidate proteins for serological diagnosis of wd. immunoreactivities of sera collected from 18 patients with wd ... | 2006 | 16637011 |
| autoimmunohistochemistry: a new method for the histologic diagnosis of infective endocarditis. | although the pathologic examination of cardiac valves remains the reference standard for the diagnosis of infective endocarditis, the detection of microorganisms often poses a challenge for pathologists. this can be done by use of nonspecific histochemical stains or by immunohistochemical analysis, but specific antibodies are often not available. we describe a novel method for the detection of microorganisms in valve specimens from patients with infective endocarditis. | 2006 | 16703515 |
| tropical sprue in two foreign residents, with evidence of tropheryma whippelii in one case. | tropical sprue is a rare disease in travelers. its etiology remains unclear. we report two cases of tropical sprue occurring in long-term residents in nepal and cameroon. in one case, tropheryma whippelii, the agent of whipple's disease, was identified. many infectious agents have been suggested to be the etiological agent of tropical sprue, but no association with whipple's disease has yet been reported. | 2006 | 16706950 |
| global transcriptome analysis of tropheryma whipplei in response to temperature stresses. | tropheryma whipplei, the agent responsible for whipple disease, is a poorly known pathogen suspected to have an environmental origin. the availability of the sequence of the 0.92-mb genome of this organism made a global gene expression analysis in response to thermal stresses feasible, which resulted in unique transcription profiles. a few genes were differentially transcribed after 15 min of exposure at 43 degrees c. the effects observed included up-regulation of the dnak regulon, which is comp ... | 2006 | 16816195 |
| neurologic manifestations of whipple's disease. | whipple's disease is a rare, multisystem, infectious disorder caused by the bacterium tropheryma whippelii. patients with central nervous system (cns) involvement may present in a variety of ways, including cognitive impairment, psychiatric manifestations, gaze palsies, upper motor neuron signs, and hypothalamic dysfunction. a tissue-based diagnosis of whipple's disease is made based on the presence of periodic acid-schiff-stained material or by the identification of bacterial rna using polymera ... | 2006 | 16822374 |
| reduced peripheral and mucosal tropheryma whipplei-specific th1 response in patients with whipple's disease. | whipple's disease is a rare infectious disorder caused by tropheryma whipplei. major symptoms are arthropathy, weight loss, and diarrhea, but the cns and other organs may be affected, too. the incidence of whipple's disease is very low despite the ubiquitous presence of t. whipplei in the environment. therefore, it has been suggested that host factors indicated by immune deficiencies are responsible for the development of whipple's disease. however, t. whipplei-specific t cell responses could no ... | 2006 | 16849516 |
| murine model of infection by tropheryma whipplei. | we developed an animal model reproducing several aspects of whipple's disease. immunocompetent mice were persistently infected with tropheryma whipplei, its etiological agent, and developed liver granulomas. scid mice were infected similarly but did not develop tissue lesions. the delayed clearance of t. whipplei suggests a protective role for innate immunity. | 2006 | 16861681 |
| primary whipple's disease of the brain: characterization of the clinical syndrome and molecular diagnosis. | whipple's disease (wd) of the brain without evidence of systemic involvement is a rare illness that is difficult to recognize and potentially life-threatening. | 2006 | 16905752 |
| whipple's disease with muscle impairment. | a 67-year-old man presented with myalgia, muscle atrophy, and a history of seronegative polyarthritis. blood tests showed inflammation but no hematologic or immunologic abnormalities. muscle biopsy revealed no vasculitis or myositis but tropheryma whipplei was detected by polymerase chain reaction in muscle, blood, and duodenum specimens; this was confirmed by immunohistochemistry. ceftriaxone led to clinical improvement. although rare, whipple's disease should be considered in the differential ... | 2006 | 16967496 |
| production of monoclonal antibodies to tropheryma whipplei and identification of recognized epitopes by two-dimensional electrophoresis and mass spectrometry. | tropheryma whipplei, the agent of whipple's disease, is a gram-positive rod-shaped bacterium that belongs to the group of actinobacteria. in order to produce monoclonal antibodies (mabs) against this bacterium, we inoculated mice with two different strains, slow2 and endo5. we produced 13 and 10 mabs against slow2 and endo5, respectively. nine of the slow2 mabs and seven of the endo5 mabs recognized a 58-kda epitope. in addition, three other endo5 mabs detected a unique 84-kda epitope. these mab ... | 2006 | 16988020 |
| the prevalence of tropheryma whippelii dna in saliva from healthy controls and patients with spondyloarthropathy. | 2007 | 17013607 |