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Whipple’s Disease Definition
Whipple’s disease is a bacterial INFECTION of the SMALL INTESTINE, also called intestinal lipodystrophy, that impairs absorption of fats (lipids). The PATHOGEN(infective BACTERIA) is Tropheryma whippelii. Though T. whippelii can infect various body systems including the HEART and the EYE, the gastrointestinal tract is its most common site.
In the small intestine the bacteria create lesions (disruptions in the continuity of the intestinal mucosa) that destroy the villi, the microscopic, fingerlike extensions of tissue where much of the intestine’s absorption functions take place. Researchers do not know how people acquire T. whippelii, though do know the infection can take years to decades to manifest symptoms.
Symptoms of Whipple’s Disease and Treatment
Symptoms include DIARRHEA, GASTROINTESTINAL BLEEDING, OSTEOARTHRITIS, MALNUTRITION, unintended weight loss, HEADACHE, and FEVER. The diagnostic path may include general blood tests, BARIUM SWALLOW with small intestine flow-through, and ENDOSCOPY with biopsy to culture a tissue sample from the inner intestine. Treatment is a course of intravenous ANTIBIOTIC MEDICATIONS, typically penicillin and streptomycin or chloramphenicol in combination, with 12 to 18 months of oral antibiotic therapy to completely eradicate the bacteria.