Whipple’s Disease: Case Report

Whipple’s disease (WD) is a rare systemic bacterial infection caused by Tropheryma whipplei, with an estimated incidence of one to three cases per million inhabitants. It commonly presents with persistent arthralgia, chronic diarrhea, abdominal pain, and weight loss, potentially affecting other systems, such as the neurological and cardiovascular systems. We report the case of a 41-year-old female patient with abdominal and pelvic pain, intermittent diarrhea, arthralgia, myalgia, night sweats, and unintentional weight loss of 5 kg over a short period. Initially, mesenteric lymphadenopathy raised suspicion of sarcoidosis. However, a duodenal biopsy revealed periodic acid-schiff (PAS)-positive macrophages, confirming the diagnosis of WD. The patient was treated with intravenous ceftriaxone, followed by oral trimethoprim-sulfamethoxazole (TMP-SMX) for one year. WD should be considered in the differential diagnosis of malabsorption syndromes and multisystemic diseases, given its progressive course and the potential benefit of early treatment.