eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-04-01 9 7 348 353 10.12691/ajmcr-9-7-2 AJMCR2021972 article Syed Hamza Bin Waqar 1 John Diks 2 Unaiza Zaman 2 Sarah Sharif 2 Taha Sheikh 3 Srinivas Kolla 4 Isabel M. McFarlane isabel.mcfarlane@downstate.edu 4 Department of Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY Department of Pathology and Lab Sciences, State University of New York, Downstate Health Sciences University, Brooklyn, NY Department of Medicine, University of Toledo, OH Department of Radiology, Chief, Musculoskeletal Division, State University of New York, Downstate Health Sciences University, Brooklyn, NY 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. http://pubs.sciepub.com/ajmcr/9/7/2/ajmcr-9-7-2.pdf Whipple¡¯s disease Tropheryma whipplei malabsorption protein-losing enteropathy