Whipple's disease and Tropheryma whipplei

Informations for the patients
Professeur Didier RAOULT
HOPITAL DE LA TIMONE
Phone. 33. 4.91.38.55.14/19
Mail : didier.raoult@medecine.univ-mrs.fr
The Whipple’s disease is caused by a bacterium called Tropheryma
whipplei. The bacterium lives probably in the environment, maybe water,
but we do not really know the source of the infection. The disease seems
to be more frequent in some geographical area, mainly, for France in
Rhône-Alpes area, but also in Switzerland and Germany.
The presentations of the disease are diverse. The most frequent
and classical form is those with digestive signs including a chronic
diarrhea, associated with a weight loss and a skin which become more
dark. This form is often associated to the presence of adenopathies or
arthralgia, which could be the first clinical signs of the disease.
Sometimes, this disease is misdiagnosed with rheumatoid polyarthritis.
In the classical from, the localization of the bacterium on the small-bowel
is systematic. This fact explains why we perform a digestive fibroscopy
with a biopsy to check for the presence of the bacterium at the beginning
and in the follow-up of the disease. Besides, the bacterium could also
infects different sites such as the brain or the cardiac valves.
Without treatment, the evolution of Whipple’s disease is always
fatale. The treatment is long (always superior to 1 year) and after the end
of the treatment, sometimes even after very long treatment, relapses are
possible, mainly in the brain. A regular follow-up of patients with
Whipple’s disease is thus necessary.
The bacterium has been cultivated for the first time in our
laboratory in Marseille (France), in 1999, allowing new perspectives for
the diagnosis and the management of this disease.