Tham khảo luận văn - đề án 'báo cáo y học: " tropheryma whipplei tricuspid endocarditis: a case report and review of the literature"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Gabus et al. Journal of Medical Case Reports 2010 4 245 http content 4 1 245 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Tropheryma whipplei tricuspid endocarditis a case report and review of the literature f r I r 171 c rr f z t I I m I r 2 c ro VI i rrw I n 3 4 Vincent Gabus Zita GrenaK-uegoumois Severin Jeanneret Kiana KaKotoarimanana Gilbert Greub Daniel Genné2 Abstract Introduction The main clinical manifestations of Whipple s disease are weight loss arthropathy diarrhea and abdominal pain. Cardiac involvement is frequently described. However endocarditis is rare and is not usually the initial presentation of the disease. To the best of our Knowledge this is the first reported case of a patient with Tropheryma whipplei tricuspid endocarditis without any other valve involved and not presenting signs of arthralgia and abdominal involvement. Case presentation We report a case of a 50-year-old Caucasian man with tricuspid endocarditis caused by Tropheryma whipplei showing signs of severe shock and an absence of other more classic clinical signs of Whipple s disease such as arthralgia abdominal pain and diarrhea. Tropheryma whipplei was documented by polymerase chain reaction of the blood and pleural fluid. The infection was treated with a combined treatment of doxycycline hydroxychloroquine and sulfamethoxazole-trimethoprim for one year. Conclusion Tropheryma whipplei infectious endocarditis should always be considered when facing a blood-culture negative endocarditis particularly in right-sided valves. Although not standardized yet treatment of Tropheryma whipplei endocarditis should probably include a bactericidal antibiotic such as doxycycline and should be given over a prolonged period of time a minimum of one year . Introduction The Gram positive bacillus Tropheryma whippelii was first characterized by polymerase chain reaction PCR in the early 1990s 1 and renamed Tropheryma whip-plei in 2001 after its first .
