Whipple's disease is a rare, systemic condition caused by Tropheryma whipplei.

PC

The disease primarily presents with diarrhoea, abdominal pain and joint pain, but can affect any part of the body including the cardiac and nervous systems.

Investigations

Whipple's disease is more common in males. Diagnosis is with a small bowel biopsy, which shows the presence of acid-Schiff (PAS)-positive macrophages, which are seen to contain the causative bacteria on electron microscopy.

Management

Treatment is with 160mg trimethoprim and 800mg sulfamethoxazole (co- trimoxazole) daily for 1year

Treatment periods of less than 1year are associated with relapse in about 40%. If left untreated, it can be fatal.