American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2021, 9(7), 348-353
DOI: 10.12691/ajmcr-9-7-2
Open AccessArticle

Refractory Effusions, Crumbly Bones, Mystifying Cachexia and an Absent Mind: An Unusual Presentation of Whipple’s Disease with Review of Literature

Syed Hamza Bin Waqar1, John Diks2, Unaiza Zaman1, Sarah Sharif1, Taha Sheikh3, Srinivas Kolla4 and Isabel M. McFarlane1,

1Department of Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY

2Department of Pathology and Lab Sciences, State University of New York, Downstate Health Sciences University, Brooklyn, NY

3Department of Medicine, University of Toledo, OH

4Department of Radiology, Chief, Musculoskeletal Division, State University of New York, Downstate Health Sciences University, Brooklyn, NY

Pub. Date: April 01, 2021

Cite this paper:
Syed Hamza Bin Waqar, John Diks, Unaiza Zaman, Sarah Sharif, Taha Sheikh, Srinivas Kolla and Isabel M. McFarlane. Refractory Effusions, Crumbly Bones, Mystifying Cachexia and an Absent Mind: An Unusual Presentation of Whipple’s Disease with Review of Literature. American Journal of Medical Case Reports. 2021; 9(7):348-353. doi: 10.12691/ajmcr-9-7-2

Abstract

Whipple’s disease is a bacterial infection caused by Tropheryma whipplei and is known to cause perplexing clinical presentations, making its diagnosis challenging. The beginning by the involvement of the gastrointestinal tract, Whipple's disease can slowly progress to affect almost any organ system and lead to chronic multi-system inflammatory disease. Hereby, we present a middle age man who initially manifested with shortness of breath and chronic weight loss. He subsequently developed pleuro-pericardial effusion, ascites, mesenteric lymphadenopathy, possible myocarditis, and severe osteopenia with multiple vertebral fractures during his illness. Esophagogastroduodenoscopy with the biopsy and subsequent molecular confirmation of disease led to the confirmation of WD. Therapeutic management included two separate antibiotic regimens in an attempt to address the refractory course of WD in this patient.

Keywords:
Whipple’s disease Tropheryma whipplei malabsorption protein-losing enteropathy

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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