Culture of <i>Tropheryma whippelii</i> from the Vitreous Fluid of a Patient Presenting with Unilateral Uveitis
Authors: Michel Drancourt, Didier Raoult, Hubert Lpidi, Florence Fnollar, Marie-Laure Birg, Bahram Bodaghi, Phuc Le Hoang, Jean-Daniel Lelivre
Journal: Annals of Internal Medicine (2003)

Letters16 December 2003Culture of Tropheryma whippelii from the Vitreous Fluid of a Patient Presenting with Unilateral UveitisMichel Drancourt, MD, PhD, Didier Raoult, MD, PhD, Hubert Lpidi, MD, PhD, Florence Fnollar, MD, Marie-Laure Birg, Bahram Bodaghi, MD, PhD, Phuc Le Hoang, MD, PhD, and Jean-Daniel Lelivre, MDMichel Drancourt, MD, PhDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., Didier Raoult, MD, PhDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., Hubert Lpidi, MD, PhDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., Florence Fnollar, MDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., Marie-Laure BirgFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., Bahram Bodaghi, MD, PhDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., Phuc Le Hoang, MD, PhDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France., and Jean-Daniel Lelivre, MDFrom Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-12-200312160-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Whipple disease is a multisystem infection by Tropheryma whippelii(1), and only 7 cases of associated bilateral uveitis have been documented. We report the first case, to our knowledge, of chronic, unilateral T. whippelii uveitis diagnosed by culture and by direct detection of organisms in the vitreous by immunohistochemical staining.Case Report: A 65-year-old man was referred with uveitis of the right eye after a 9-year history of presumptive sarcoidosis. Visual acuity was 20/400 OD and 20/20 OS, with severe intermediate uveitis, a 3+vitreitis OD (partly explaining floaters and loss of vision), peripheral vasculitis cystoid macular edema, ...References1. Raoult D, Birg ML, La Scola B, Fournier PE, Enea M, Lepidi H, . Cultivation of the bacillus of Whipple's disease. N Engl J Med. 2000;342:620-5. [PMID: 10699161] CrossrefMedlineGoogle Scholar2. Raoult D, Lepidi H, Harle JR. Tropheryma whipplei circulating in blood monocytes [Letter]. N Engl J Med. 2001;345:548. [PMID: 11519522] CrossrefMedlineGoogle Scholar3. Hinrikson HP, Dutly F, Altwegg M. Evaluation of a specific nested PCR targeting domain III of the 23S rRNA gene of Tropheryma whippelii and proposal of a classification system for its molecular variants. J Clin Microbiol. 2000;38:595-9. [PMID: 10655352] CrossrefMedlineGoogle Scholar4. Bodaghi B, Dauga C, Cassoux N, Wechsler B, Merle-Beral H, Poveda JD, . Whipple's syndrome (uveitis, B27-negative spondylarthropathy, meningitis, and lymphadenopathy) associated with Arthrobacter sp. infection. Ophthalmology. 1998;105:1891-6. [PMID: 9787360] CrossrefMedlineGoogle Scholar5. Williams JG, Edward DP, Tessler HH, Persing DH, Mitchell PS, Goldstein DA. Ocular manifestations of Whipple disease: an atypical presentation. Arch Ophthalmol. 1998;116:1232-4. [PMID: 9747687] CrossrefMedlineGoogle Scholar6. Rickman LS, Freeman WR, Green WR, Feldman ST, Sullivan J, Russack V, . Brief report: uveitis caused by Tropheryma whippelii (Whipple's bacillus). N Engl J Med. 1995;332:363-6. [PMID: 7529892] CrossrefMedlineGoogle Scholar7. Ehrbar HU, Bauerfeind P, Dutly F, Koelz H.R, Altwegg M. PCR-positive tests for Tropheryma whippelii in patients without Whipple's disease [Letter]. Lancet. 1999;353:2214. [PMID: 10392994] CrossrefMedlineGoogle Scholar8. Street S, Donoghue HD, Neild GH. Tropheryma whippelii DNA in saliva of healthy people [Letter]. Lancet. 1999;354:1178-9. [PMID: 10513716] CrossrefMedlineGoogle Scholar9. Font RI, Rao NA, Issarescu S, McEntee WJ. Ocular involvement in Whipple's disease: light and electron microscopic observations. Arch Ophthalmol. 1978;96:1434-6. CrossrefGoogle Scholar10. Avila MP, Jalkh AE, Feldman E, Trempe CL, Schepens CL. Manifestations of Whipple's disease in the posterior segment of the eye. Arch Ophthalmol. 1984;102:384-90. [PMID: 6200096] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michel Drancourt, MD, PhD; Didier Raoult, MD, PhD; Hubert Lpidi, MD, PhD; Florence Fnollar, MD; Marie-Laure Birg; Bahram Bodaghi, MD, PhD; Phuc Le Hoang, MD, PhD; Jean-Daniel Lelivre, MDAffiliations: From Unit des Rickettsie, 13385 Marseille, France; Hpital de la Piti-Salptrire, 75013 Paris, France; and Hpital Bichat, 75877 Paris, France.Acknowledgments: The authors acknowledge Dr. Patrick Kelly for reviewing the manuscript.Grant Support: By a grant of Programme Hospitalier de Recherche Clinique 2001, Assistance Publique Hpitaux de Marseille (AP-HM). 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