Isolated Whipple's endocarditis: an underestimated diagnosis that requires molecular analysis of surgical material

Ann Thorac Surg. 2014 Jul;98(1):e1-3. doi: 10.1016/j.athoracsur.2014.04.059.

Abstract

Tropheryma whipplei is known as the bacterium that causes Whipple's disease, a rare systemic illness typically affecting gastrointestinal tract, joints, and central nervous system. In addition, T whipplei infection may present as an isolated endocarditis. Although previously regarded as a rare condition, T whipplei has been recognized as a major cause of culture-negative endocarditis when integrating specific molecular analysis of surgical material into the diagnostic algorithm. Here, we report the case of a 67-year-old man undergoing mitral valve replacement due to T whipplei endocarditis, and discuss diagnostic and therapeutic implications.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • DNA, Bacterial / analysis*
  • Diagnosis, Differential
  • Echocardiography
  • Endocarditis, Bacterial / diagnosis*
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / therapy
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Male
  • Mitral Valve / microbiology
  • Mitral Valve / pathology
  • Mitral Valve / surgery*
  • Molecular Diagnostic Techniques / methods*
  • Tropheryma / genetics*
  • Tropheryma / isolation & purification
  • Whipple Disease / diagnosis
  • Whipple Disease / microbiology
  • Whipple Disease / therapy

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial