Ocular manifestations of Whipple disease: An atypical presentation

Jonathan G. Williams; Deepak P. Edward; Howard H. Tessler; David H. Persing; P. Shawn Mitchell; Debra A. Goldstein

doi:10.1001/archopht.116.9.1232

Ocular manifestations of Whipple disease: An atypical presentation

Jonathan G. Williams, Deepak P. Edward, Howard H. Tessler, David H. Persing, P. Shawn Mitchell, Debra A. Goldstein^*

^*Corresponding author for this work

Ophthalmology

Research output: Contribution to journal › Article › peer-review

32 Scopus citations

Abstract

A 62-year-old man developed bilateral granulomatous iridocyclitis after uncomplicated cataract surgery. On ophthalmic examination, we found moderate inflammation in the anterior chamber and vitreous, with granular crystalline deposits on the iris, intraocular lens, and capsular bag. Biopsy of the lens capsule and vitreous revealed periodic acid-Schiff-positive, diastase- resistant bacilli consistent with Tropheryma whippelii. Electron microscopy and polymerase chain reaction confirmed the diagnosis of Whipple disease. A jejunal biopsy specimen also revealed T whippelii. Treatment with trimethoprim-sulfamethoxazole, cefixime, rifampin, and doxycycline resulted in improvement of systemic symptoms, but intraocular inflammation persisted. Intraocular inflammation was eventually reduced with the intravenous administration of ceftriaxone sodium.

Original language	English (US)
Pages (from-to)	1232-1234
Number of pages	3
Journal	Archives of ophthalmology
Volume	116
Issue number	9
DOIs	https://doi.org/10.1001/archopht.116.9.1232
State	Published - Sep 1998

ASJC Scopus subject areas

Ophthalmology

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title = "Ocular manifestations of Whipple disease: An atypical presentation",

abstract = "A 62-year-old man developed bilateral granulomatous iridocyclitis after uncomplicated cataract surgery. On ophthalmic examination, we found moderate inflammation in the anterior chamber and vitreous, with granular crystalline deposits on the iris, intraocular lens, and capsular bag. Biopsy of the lens capsule and vitreous revealed periodic acid-Schiff-positive, diastase- resistant bacilli consistent with Tropheryma whippelii. Electron microscopy and polymerase chain reaction confirmed the diagnosis of Whipple disease. A jejunal biopsy specimen also revealed T whippelii. Treatment with trimethoprim-sulfamethoxazole, cefixime, rifampin, and doxycycline resulted in improvement of systemic symptoms, but intraocular inflammation persisted. Intraocular inflammation was eventually reduced with the intravenous administration of ceftriaxone sodium.",

author = "Williams, {Jonathan G.} and Edward, {Deepak P.} and Tessler, {Howard H.} and Persing, {David H.} and Mitchell, {P. Shawn} and Goldstein, {Debra A.}",

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T2 - An atypical presentation

AU - Williams, Jonathan G.

AU - Edward, Deepak P.

AU - Tessler, Howard H.

AU - Persing, David H.

AU - Mitchell, P. Shawn

AU - Goldstein, Debra A.

PY - 1998/9

Y1 - 1998/9

N2 - A 62-year-old man developed bilateral granulomatous iridocyclitis after uncomplicated cataract surgery. On ophthalmic examination, we found moderate inflammation in the anterior chamber and vitreous, with granular crystalline deposits on the iris, intraocular lens, and capsular bag. Biopsy of the lens capsule and vitreous revealed periodic acid-Schiff-positive, diastase- resistant bacilli consistent with Tropheryma whippelii. Electron microscopy and polymerase chain reaction confirmed the diagnosis of Whipple disease. A jejunal biopsy specimen also revealed T whippelii. Treatment with trimethoprim-sulfamethoxazole, cefixime, rifampin, and doxycycline resulted in improvement of systemic symptoms, but intraocular inflammation persisted. Intraocular inflammation was eventually reduced with the intravenous administration of ceftriaxone sodium.

AB - A 62-year-old man developed bilateral granulomatous iridocyclitis after uncomplicated cataract surgery. On ophthalmic examination, we found moderate inflammation in the anterior chamber and vitreous, with granular crystalline deposits on the iris, intraocular lens, and capsular bag. Biopsy of the lens capsule and vitreous revealed periodic acid-Schiff-positive, diastase- resistant bacilli consistent with Tropheryma whippelii. Electron microscopy and polymerase chain reaction confirmed the diagnosis of Whipple disease. A jejunal biopsy specimen also revealed T whippelii. Treatment with trimethoprim-sulfamethoxazole, cefixime, rifampin, and doxycycline resulted in improvement of systemic symptoms, but intraocular inflammation persisted. Intraocular inflammation was eventually reduced with the intravenous administration of ceftriaxone sodium.

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Ocular manifestations of Whipple disease: An atypical presentation

Abstract

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