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
American Journal of Medical Case Reports.
2021,
Vol. 9 No. 7, 348-353
DOI: 10.12691/ajmcr-9-7-2
Copyright © 2021 Science and Education PublishingCite this paper: Syed Hamza Bin Waqar, John Diks, Unaiza Zaman, Sarah Sharif, Taha Sheikh, Srinivas Kolla, 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.
Correspondence to: Isabel M. McFarlane, Department of Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY. Email:
isabel.mcfarlane@downstate.eduAbstract
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.
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