Introduction
Systemic tissue damage characterized by macrophages loaded with Tropheryma whipplei; partially destroyed organisms are present in macrophage lysosomes (positive for PAS).
Etiologic agent
Epidemiology
Pathogenesis and pathology
Small bowel lamina propria
Macrophages compress lacteals.
Chylomicrons cannot be transferred from enterocytes to lymphatics.
Results in fat malabsorption and steatorrhea
Intense pink discoloration – PAS stain is particularly effective at highlighting polysaccharides of the fungal cell wall, mucosubstances secreted by epithelia, and basement membranes.
Others
Synovium of joints (arthritis)
Cardiac valves
Lymph nodes
CNS.
Clinical manifestations
Asymptomatic colonization/carriage
Acute infection
Chronic infection
- “Classic” Whipple’s disease
- Neurologic disease
- Cardiac disease
- Pulmonary disease
- Lymphatic disease
- Ocular disease
- Dermatologic disease
- Miscellaneous sites
- Isolated infection
- Reinfection/relapsing disease/immune reconstitution inflammatory syndrome (IRIS)
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