Whipple disease presenting as posterior uveitis without prominent gastrointestinal symptoms

Am J Ophthalmol. 1998 Jul;126(1):130-2. doi: 10.1016/s0002-9394(98)00084-1.

Abstract

Purpose: To describe the clinical presentation and course of Whipple disease in an adult.

Methods: A 34-year-old man with phthisis bulbi in the right eye secondary to uveitis-induced neovascular glaucoma presented with severe acute posterior uveitis in the left eye. He underwent esophagogastroduodenoscopy and jejunal biopsy for evaluation of anemia. The posterior uveitis was treated with a subtenon injection of triamcinolone.

Result: The diagnosis of Whipple disease was confirmed by polymerase chain reaction analysis of the jejunal biopsy that demonstrated Tropheryma whippelii rDNA.

Conclusion: Although Whipple disease is typically evident with malabsorption, it can also present as uveitis without prominent gastrointestinal symptoms.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actinobacteria / genetics
  • Actinobacteria / isolation & purification
  • Actinomycetales Infections / diagnosis*
  • Actinomycetales Infections / drug therapy
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • DNA, Bacterial / analysis
  • Drug Therapy, Combination
  • Endoscopy, Digestive System
  • Glucocorticoids / therapeutic use
  • Humans
  • Jejunum / microbiology
  • Jejunum / pathology
  • Male
  • Polymerase Chain Reaction
  • Triamcinolone Acetonide / therapeutic use
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Uveitis, Posterior / diagnosis*
  • Uveitis, Posterior / drug therapy
  • Whipple Disease / diagnosis*
  • Whipple Disease / drug therapy

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial
  • Glucocorticoids
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Triamcinolone Acetonide