CASE REPORT   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2025 January-February;184(1-2):134-9

DOI: 10.23736/S0393-3660.24.05506-2

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lingua: Inglese

Diagnostic challenges in Whipple’s disease

Claudemira PINTO ✉, Ana FACEIRA, Marina MENDES, Marta D. MARTINS, Tiago J. VALENTE, Filipe MARTINS, Fernando FRIÕES, Filipa CEIA

Department of Internal Medicine, São João Hospital Center, Porto, Portugal

Whipple’s disease (WD) is a rare, chronic, systemic infectious disorder with prominent intestinal manifestations caused by Tropheryma whipplei. The authors present the case of a 62-year-old man with systemic symptoms for a year, which at the time of assessment in our hospital included periods of confusion and visual hallucinatory activity, generalized tonic-clonic seizures, aphasia, right hemianopsia, changes in sleep-wake cycle, and history of asthenia and migratory arthralgia. Previously it was studied with several complementary diagnostic tests, which showed pericardial effusion, supradiaphragmatic lymphadenopathy, micronodules in the lung, and cortico-subcortical temporal, occipital, and left posterior parietal lesion in the brain. He was admitted to our hospital without a definitive diagnosis, after considering the hypotheses of tuberculosis and lymphoma. After an exhaustive review, mainly of the clinical and epidemiological history, it was possible to diagnose WD.

KEY WORDS: Whipple disease; Tropheryma; Neurology