Tropheryma whipplei aortic valve endocarditis, cured without surgical treatment

• Published in: BMC research notes Vol. 5; no. 1; p. 600
• Main Authors: Algin, Ahmet, Wegdam-Blans, Marjolijn, Verduin, Kees, Janssen, Hans, van Dantzig, Jan-Melle
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.10.2012; BioMed Central; BMC
• Subjects: Antibiotics; Aortic valve; Aortic Valve - diagnostic imaging; Aortic Valve - microbiology; Biopsy; Blood; Case Report; Case reports; Communicable diseases; Diagnosis; Echocardiography; Echocardiography, Transesophageal; Edetic acid; Endocarditis; Endocarditis, Bacterial - diagnostic imaging; Endocarditis, Bacterial - therapy; Heart; Heart valve diseases; Humans; Macrophages; Male; Medical examination; Middle Aged; Polymerase Chain Reaction; Stains; Surgery; Treatment Outcome; Tropheryma - isolation & purification; Tropheryma whipplei; Vegetation; Whipple Disease - diagnostic imaging; Whipple Disease - therapy; Whipple's disease
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/1756-0500-5-600

Culture-negative endocarditis due to Tropheryma whipplei is a rare disease. Mostly the diagnosis is made by histologic examination of resected heart valve tissue. In this case report, we described a patient with a classical Whipple's disease. Transesophageal echocardiography (TEE) showed a vegetation on noncoronary cusp of the aortic valve. Whipple's disease was confirmed by positive Tropheryma whipplei polymerase chain reaction (PCR) in EDTA blood and a duodenal biopsy with positive periodic acid-Schiff stain (PAS) macrophages. Due to timely diagnosis, our patient was treated with antibiotics without valve replacement.