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Chapter 64 :

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Abstract:

, a rod-shaped, environmental actinomycete with a distinct genome and typical periodic acid-Schiff (PAS) stain reaction, is the causative bacterium of Whipple’s disease (WD). PCR studies have shown the presence of in sewage plants and in human stools and saliva. WD may occur in the following clinical categories and courses: (i) classical WD, which presents with weight loss, diarrhea, and arthropathy in 75% of patients by the time of diagnosis; (ii) isolated infection of cardiac valves without classical WD; (iii) asymptomatic carriers of . The most frequent diagnostic samples are small bowel biopsy specimens. Endoscopic biopsies, at least four to six, from the distal duodenum and/or the jejunum, even in the absence of intestinal symptoms, should also be obtained systematically in suspected WD, because involvement could be patchy. has only recently been cultured in human fibroblasts based on specific cell culture techniques. The use of parenteral therapy was recently clarified in a randomized controlled trial with 40 WD patients; this study also demonstrated a very high clinical remission rate if antimicrobial therapy was closely monitored.

Citation: Marth T. 2011. , p 1035-1039. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch64

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Bacterial Cell Wall
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Real-Time PCR
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Amino Acid Synthesis
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Randomized Controlled Trial
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Figures

Image of FIGURE 1
FIGURE 1

PAS stain of a duodenal biopsy specimen in a patient with WD. Large numbers of purple-stained macrophages in the lamina propria can be seen. Magnification, ×31.

Citation: Marth T. 2011. , p 1035-1039. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch64
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Image of FIGURE 2
FIGURE 2

Electron microscopic appearance of Magnification, ×23,100.

Citation: Marth T. 2011. , p 1035-1039. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch64
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Image of FIGURE 3
FIGURE 3

Algorithm for WD diagnosis and monitoring.

Citation: Marth T. 2011. , p 1035-1039. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch64
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References

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Tables

Generic image for table
TABLE 1

Diagnostic tools for the diagnosis of WD

Citation: Marth T. 2011. , p 1035-1039. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch64

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