Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report
| Autor: | Mario Madruga, Li Ge, Carmelo Licitra, Maxim Olivier, Zachary Field, Steve J. Carlan, Dustin Hill |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Abdominal pain Pediatrics medicine.medical_specialty Malabsorption 030106 microbiology Tropheryma Case Report lcsh:Infectious and parasitic diseases Tropheryma whipplei 03 medical and health sciences 0302 clinical medicine Humans Medicine Endocarditis lcsh:RC109-216 030212 general & internal medicine Whipple's disease biology Platelet Count business.industry Endocarditis Bacterial Middle Aged medicine.disease biology.organism_classification Thrombocytopenia Anti-Bacterial Agents Diarrhea Infectious Diseases Joint pain Failure to thrive Whipple’s disease medicine.symptom Embolic stroke business Whipple Disease |
| Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-6 (2020) |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-020-4799-0 |
| Popis: | Background Whipple’s disease (WD) is a rare multisystem infectious disorder that is caused by the actinomycete Tropheryma whipplei. It presents with joint pain followed by abdominal pain, diarrhea, malabsorption and finally failure to thrive. Diagnosis requires tissue sampling and histology with periodic acid-Schiff [PAS] staining. Thrombocytopenia associated with endocarditis associated with WD has been reported twice. Case presentation A 56 year old Caucasian male presented with years of steroid treated joint pain and recent onset diarrhea, weight loss and abdominal pain. Ultimately he was found to have a platelet count of 4000 with concomitant endocarditis and embolic stroke. Small bowel biopsy confirmed the diagnosis of WD approximately 1 year after his first visit. His platelets improved with antibiotic treatment but he eventually expired 16 months after his initial consult and 5 months after his definitive diagnosis. Conclusion WD can remain undiagnosed and untreated until late in the course of the illness. A high index of suspicion is recognized as necessary for early diagnosis to begin treatment. Critical thrombocytopenia associated with endocarditis is a rare and potentially poor prognostic sign in late stage Whipple’s disease. |
| Databáze: | OpenAIRE |
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