Jos Sarah-Lyne, Angelakis Emmanouil, Caus Thierry, Raoult Didier
URMITE CNRS-IRD 198 UMR 6236, Aix Marseille Université, Faculté de Médecine et de Pharmacie, 27 Bd Jean Moulin, 13385, Marseille, France.
INSERM, ERI-12 (EA 4292), University of Picardie, Department of Cardiac Surgery, University Hospital Amiens, Avenue René Laënnec - Salouël, 80054, Amiens, France.
BMC Res Notes. 2015 Feb 26;8:56. doi: 10.1186/s13104-015-1022-2.
Whipple's disease is a systemic infection that sometimes is associated with cardiac manifestations. The diagnosis of Tropheryma whipplei endocarditis is still the result of chance because there are no diagnostic criteria and clinical signs are often those of cardiac disease rather than infection.
Culture-negative endocarditis was suspected in a non-febrile 77-year-old French woman from North France with a history of a graft replacement 4 years prior. Positron emission tomography revealed intense fluorodeoxyglucose uptake around the metal ring of the aortic graft. The valve was replaced, and T. whipplei was detected in a valve sample by molecular assays. Immunohistochemical staining of the valve for T. whipplei was also positive.
The localization of infectious foci by positron emission tomography and systematically testing valve specimens for T. whipplei are promising for diagnosing Whipple's disease.
惠普尔病是一种全身性感染，有时伴有心脏表现。由于缺乏诊断标准且临床症状常表现为心脏病而非感染症状，因此惠普尔放线杆菌性心内膜炎的诊断仍靠偶然发现。
一名来自法国北部的77岁非发热法国女性，4年前有移植置换史，怀疑患有培养阴性的心内膜炎。正电子发射断层扫描显示主动脉移植金属环周围有强烈的氟脱氧葡萄糖摄取。更换了瓣膜，通过分子检测在瓣膜样本中检测到惠普尔放线杆菌。瓣膜的惠普尔放线杆菌免疫组织化学染色也呈阳性。
正电子发射断层扫描定位感染灶并对瓣膜标本进行惠普尔放线杆菌系统检测，对惠普尔病的诊断很有前景。
