Oculo-facial-skeletal myorhythmia in Whipple disease: treatment with ceftriaxone

Article Abstract:

Whipple disease is a chronic disorder that affects the entire body. It results in steatorrhea or fatty stools, weight loss, arthralgia or joint pain, fever, and nerve-related symptoms. Some central nervous system changes include headache, seizures, and meningitis, or inflammation of the membrane lining the brain and spinal cord. Patients with Whipple disease display a movement disorder called oculomasticatory or oculo-facial-skeletal myorhythmia. A case is described of a 43-year-old man with Whipple disease, who developed amnesia, meningitis, eye paralysis, and oculo-facial-skeletal myorhythmia. He improved after penicillin treatment, but suffered a central nervous system relapse. He developed amnesia, recurrent headaches, and myorhythmia. These symptoms resolved after inpatient treatment with the antibiotic ceftriaxone, which was administered intravenously (by IV). When he was discharged home, he continued to take another antibiotic, doxycycline. Nerve-related symptoms in Whipple disease do not commonly respond to therapy, but disease progression can be prevented by antibiotics, such as chloramphenicol, trimethoprim-sulfamethoxazole, tetracycline, and erythromycin. This is the first report of successful treatment of nerve-related symptoms of Whipple disease with the antibiotic ceftriaxone. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Evaluation, Central nervous system diseases, Ceftriaxone, Ceftriaxone sodium

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Detection of a clonal BCL2 gene rearrangement in tissues from a patient with Whipple disease

Article Abstract:

Antibiotic treatment may be effective in patients with Whipple disease who also have genetic evidence for an encapsulated type of lymph cancer called follicular lymphoma. Whipple disease is a rare bacterial infection. Researchers presented the medical history of a 44-year old patient suspected of having a lymphoma in the abdomen. Tissue sample tests indicated that the patient had Whipple disease. Initial tests on the patient's blood, lymph and bone marrow samples showed a gene rearrangement consistent with follicular lymphoma. There was no other evidence of lymphoma in this patient. Symptoms improved and the gene rearrangement was not present 3 and 12 months following treatment with penicillin, tobramycin, and trimethoprim-sulfamethoxazole.

Antibiotics, Drug therapy, Genetic aspects, Lymphoma, Giant follicular

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