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Infection
Published in: Infection 4/2019

01-08-2019 | Case Report

Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis

Authors: Didier Brönnimann, Marc-Olivier Vareil, Igor Sibon, Jean-Christophe Lagier, Hubert Lepidi, Mathilde Puges, Fatiha Haneche, Didier Raoult, Arnaud Desclaux, Didier Neau, Charles Cazanave

Published in: Infection | Issue 4/2019

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Abstract

Introduction

Many clinical manifestations can be related to Tropheryma whipplei infection.

Case report

We report a Tropheryma whipplei limbic encephalitis developed as a relapse of classical Whipple’s disease.

Discussion

This case is to the best of our knowledge the first proof of the effective brain–blood barrier crossing of both doxycycline and hydroxychloroquine as demonstrated by direct concentration monitoring on brain biopsy.
Literature
1.
2.
Mohamed W, Neil E, Kupsky WJ, Juhász C, Mittal S, Santhakumar S. Isolated intracranial Whipple’s disease–report of a rare case and review of the literature. J Neurol Sci. 2011;308:1–8.CrossRefPubMed
3.
Fenollar F, Nicoli F, Paquet C, Lepidi H, Cozzone P, Antoine J-C, et al. Progressive dementia associated with ataxia or obesity in patients with Tropheryma whipplei encephalitis. BMC Infect Dis. 2011;11:171.CrossRefPubMedPubMedCentral
4.
Blanc F, Ben Abdelghani K, Schramm F, Jaulhac B, Chatelus E, Sordet C, et al. Whipple limbic encephalitis. Arch Neurol. 2011;68:1471–3.CrossRefPubMed
5.
Black DF, Aksamit AJ, Morris JM. MR imaging of central nervous system Whipple disease: a 15-year review. AJNR Am J Neuroradiol. 2010;31:1493–7.CrossRefPubMed
6.
Fenollar F, Lagier J-C, Raoult D. Tropheryma whipplei and Whipple’s disease. J Infect. 2014;69:103–12.CrossRefPubMed
7.
Lagier J-C, Fenollar F, Lepidi H, Giorgi R, Million M, Raoult D. Treatment of classic Whipple’s disease: from in vitro results to clinical outcome. J Antimicrob Chemother. 2014;69:219–27.CrossRefPubMed
8.
Oyanguren B, Sánchez V, González FJ, de Felipe A, Esteban L, López-Sendón JL, et al. Limbic encephalitis: a clinical-radiological comparison between herpetic and autoimmune etiologies. Eur J Neurol. 2013;20:1566–70.CrossRefPubMed
9.
Scheid R, Lincke T, Voltz R, von Cramon DY, Sabri O. Serial 18F-fluoro-2-deoxy-d-glucose positron emission tomography and magnetic resonance imaging of paraneoplastic limbic encephalitis. Arch Neurol. 2004;61:1785–9.CrossRefPubMed
10.
Lagier J-C, Fenollar F, Koric L, Guedj E, Ceccaldi M, Raoult D. Weight loss, dementia and ataxia susceptible to doxycycline: a likely new case report caused by T. whipplei. Rev Médecine Interne Fondée Par Société Natl Francaise Médecine Interne. 2013;34:641–4.CrossRef
11.
Fenollar F, Perreal C, Raoult D. Tropheryma whipplei natural resistance to trimethoprim and sulphonamides in vitro. Int J Antimicrob Agents. 2014;43:388–90.CrossRefPubMed
12.
Feurle GE, Moos V, Schneider T, Fenollar F, Raoult D. The combination of chloroquine and minocycline, a therapeutic option in cerebrospinal infection of Whipple’s disease refractory to treatment with ceftriaxone, meropenem and co-trimoxazole. J Antimicrob Chemother. 2012;67:1295–6.CrossRefPubMed
13.
Lagier J-C, Fenollar F, Lepidi H, Raoult D. Evidence of lifetime susceptibility to Tropheryma whipplei in patients with Whipple’s disease. J Antimicrob Chemother. 2011;66:1188–9.CrossRefPubMed
Metadata
Title
Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis
Authors
Didier Brönnimann
Marc-Olivier Vareil
Igor Sibon
Jean-Christophe Lagier
Hubert Lepidi
Mathilde Puges
Fatiha Haneche
Didier Raoult
Arnaud Desclaux
Didier Neau
Charles Cazanave
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 4/2019
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-018-1173-x

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