Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report
Abstract 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...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-01-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-020-4799-0 |
| _version_ | 1818720207703638016 |
|---|---|
| author | Maxim Olivier Carmelo Licitra Zachary Field Li Ge Dustin Hill Mario Madruga S. J. Carlan |
| author_facet | Maxim Olivier Carmelo Licitra Zachary Field Li Ge Dustin Hill Mario Madruga S. J. Carlan |
| author_sort | Maxim Olivier |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-17T20:19:10Z |
| format | Article |
| id | doaj.art-bb23944ffe38403e86bd3d704d7a3960 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-17T20:19:10Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-bb23944ffe38403e86bd3d704d7a39602022-12-21T21:34:00ZengBMCBMC Infectious Diseases1471-23342020-01-012011610.1186/s12879-020-4799-0Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case reportMaxim Olivier0Carmelo Licitra1Zachary Field2Li Ge3Dustin Hill4Mario Madruga5S. J. Carlan6Department of Medicine, Orlando Regional HealthcareDivision of Infectious Diseases, Orlando Regional HealthcareDepartment of Medicine, Orlando Regional HealthcareDepartment of Pathology, Orlando Regional HealthcareDivision of Cardiology, Orlando Regional HealthcareDepartment of Medicine, Orlando Regional HealthcareDivision of Academic Affairs and Research, Orlando Regional HealthcareAbstract 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.https://doi.org/10.1186/s12879-020-4799-0ThrombocytopeniaWhipple’s diseaseEndocarditisEmbolic strokeMalabsorption |
| spellingShingle | Maxim Olivier Carmelo Licitra Zachary Field Li Ge Dustin Hill Mario Madruga S. J. Carlan Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report BMC Infectious Diseases Thrombocytopenia Whipple’s disease Endocarditis Embolic stroke Malabsorption |
| title | Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report |
| title_full | Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report |
| title_fullStr | Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report |
| title_full_unstemmed | Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report |
| title_short | Thrombocytopenia and endocarditis in a patient with Whipple’s disease: case report |
| title_sort | thrombocytopenia and endocarditis in a patient with whipple s disease case report |
| topic | Thrombocytopenia Whipple’s disease Endocarditis Embolic stroke Malabsorption |
| url | https://doi.org/10.1186/s12879-020-4799-0 |
| work_keys_str_mv | AT maximolivier thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport AT carmelolicitra thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport AT zacharyfield thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport AT lige thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport AT dustinhill thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport AT mariomadruga thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport AT sjcarlan thrombocytopeniaandendocarditisinapatientwithwhipplesdiseasecasereport |