Tropheryma whipplei infection presenting as indolent endophthalmitis
Tropheryma whipplei (T. whipplei) infection can be difficult to diagnose due to its variable clinical manifestations and the limitations of standard diagnostic tests. This case describes a 78-year-old male with blurry vision and floaters in his right eye five months after cataract surgery, along wit...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | IDCases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250925000332 |
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| author | Rami Waked Jeffrey K. Moore Brandon Winward Sophia Ham Howard W. Hoyt Leyla Azis |
| author_facet | Rami Waked Jeffrey K. Moore Brandon Winward Sophia Ham Howard W. Hoyt Leyla Azis |
| author_sort | Rami Waked |
| collection | DOAJ |
| description | Tropheryma whipplei (T. whipplei) infection can be difficult to diagnose due to its variable clinical manifestations and the limitations of standard diagnostic tests. This case describes a 78-year-old male with blurry vision and floaters in his right eye five months after cataract surgery, along with new onset weight loss and arthralgias. Ophthalmologic examination revealed inflammation and posterior vitritis, and vitreous biopsy identified T. whipplei via broad-range bacterial PCR, despite negative vitreous cultures and unremarkable flow cytometry. Gastrointestinal endoscopic and cerebrospinal fluid studies revealed no pathological or molecular evidence of the disease, complicating the diagnosis. Treatment with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole for 12 months resulted in resolution of symptoms and inflammation, with normalization of laboratory markers. This case underscores the diagnostic utility of broad-range bacterial PCR in atypical infections and highlights Whipple infection as a differential diagnosis in ocular presentations. Comprehensive interdisciplinary evaluation was critical for effective management. |
| format | Article |
| id | doaj-art-7ec12f97a8f14f038912cc26d929977b |
| institution | Kabale University |
| issn | 2214-2509 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj-art-7ec12f97a8f14f038912cc26d929977b2025-02-07T04:47:32ZengElsevierIDCases2214-25092025-01-0139e02178Tropheryma whipplei infection presenting as indolent endophthalmitisRami Waked0Jeffrey K. Moore1Brandon Winward2Sophia Ham3Howard W. Hoyt4Leyla Azis5Infectious Diseases, MaineHealth Medical Center, Portland, Maine, USA; Correspondence to: Maine Medical Centre, 22 Bramhall St, Portland, Maine 04102, USA.Ophthalmology, MaineHealth Maine Medical Center, Portland, Maine, USAOphthalmology, UT Southwestern Medical Center, Dallas, TX, United StatesOphthalmology, MaineHealth Maine Medical Center, Portland, Maine, USAOphthalmology, Pen Bay Medical Center, Rockport, Maine, USAInfectious Diseases, MaineHealth Medical Center, Portland, Maine, USATropheryma whipplei (T. whipplei) infection can be difficult to diagnose due to its variable clinical manifestations and the limitations of standard diagnostic tests. This case describes a 78-year-old male with blurry vision and floaters in his right eye five months after cataract surgery, along with new onset weight loss and arthralgias. Ophthalmologic examination revealed inflammation and posterior vitritis, and vitreous biopsy identified T. whipplei via broad-range bacterial PCR, despite negative vitreous cultures and unremarkable flow cytometry. Gastrointestinal endoscopic and cerebrospinal fluid studies revealed no pathological or molecular evidence of the disease, complicating the diagnosis. Treatment with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole for 12 months resulted in resolution of symptoms and inflammation, with normalization of laboratory markers. This case underscores the diagnostic utility of broad-range bacterial PCR in atypical infections and highlights Whipple infection as a differential diagnosis in ocular presentations. Comprehensive interdisciplinary evaluation was critical for effective management.http://www.sciencedirect.com/science/article/pii/S2214250925000332Tropheryma whippleiWhipple’s diseasePolymerase Chain ReactionRNARibosomal16S |
| spellingShingle | Rami Waked Jeffrey K. Moore Brandon Winward Sophia Ham Howard W. Hoyt Leyla Azis Tropheryma whipplei infection presenting as indolent endophthalmitis IDCases Tropheryma whipplei Whipple’s disease Polymerase Chain Reaction RNA Ribosomal 16S |
| title | Tropheryma whipplei infection presenting as indolent endophthalmitis |
| title_full | Tropheryma whipplei infection presenting as indolent endophthalmitis |
| title_fullStr | Tropheryma whipplei infection presenting as indolent endophthalmitis |
| title_full_unstemmed | Tropheryma whipplei infection presenting as indolent endophthalmitis |
| title_short | Tropheryma whipplei infection presenting as indolent endophthalmitis |
| title_sort | tropheryma whipplei infection presenting as indolent endophthalmitis |
| topic | Tropheryma whipplei Whipple’s disease Polymerase Chain Reaction RNA Ribosomal 16S |
| url | http://www.sciencedirect.com/science/article/pii/S2214250925000332 |
| work_keys_str_mv | AT ramiwaked tropherymawhippleiinfectionpresentingasindolentendophthalmitis AT jeffreykmoore tropherymawhippleiinfectionpresentingasindolentendophthalmitis AT brandonwinward tropherymawhippleiinfectionpresentingasindolentendophthalmitis AT sophiaham tropherymawhippleiinfectionpresentingasindolentendophthalmitis AT howardwhoyt tropherymawhippleiinfectionpresentingasindolentendophthalmitis AT leylaazis tropherymawhippleiinfectionpresentingasindolentendophthalmitis |