Journal Article

Cerebral Relapse of Sarcoidlike Whipple's Disease

F. P. J. Peters, R. S. M. E. Wouters, A. P. de Bruine and R. W. Stockbrügger

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 24, issue 6, pages 1252-1255
Published in print June 1997 | ISSN: 1058-4838
Published online June 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/513630
Cerebral Relapse of Sarcoidlike Whipple's Disease

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Whipple's disease, an infection with the recently identified intracellular bacillus Tropheryma whippelii, is a systemic disorder that can be life threatening when untreated. In a few patients, the signs and symptoms of the disease are similar to those of sarcoidosis, and this illness is referred to as sarcoidlike Whipple's disease. This variant must be recognized because patients with sarcoidlike Whipple's disease must be treated with antibiotics instead of corticosteroids, which would be indicated for patients with true sarcoidosis. We describe a 53-year-old man who had sarcoidlike Whipple's disease with polyvisceral granulomatous dissemination that was treated with procaine penicillin G and streptomycin followed by doxycycline. His condition initially improved. However, during his 4-month course of treatment he developed a cerebral relapse; this relapse was successfully treated with ceftriaxone and cefixime.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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