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Whipple disease
Whipple disease
Clinical features Whipple disease is a rare, chronic multisystem infective disorder caused by Tropheryma whipplei, a Gram-positive bacillus and member of the actinomycetes.1โ4 In its classic form, the condition has a propensity to occur in middle-aged Caucasian males. The gastrointestinal tract is the main target of infection, resulting in low-grade fever, weight loss, abdominal pain, diarrhea, and malabsorption syndrome.1,3 The known clinical spectrum has, however, broadened in recent years. Some patients have localized disease confined to organs outside of the alimentary tract. Potential manifestations include lymphadenopathy, seronegative arthritis, neurological signs, uveitis, endocarditis, and pleuritis, often in the absence of concomitant gastrointestinal symptoms.1โ3 Others may present with acute, self-limiting infections such as acute pneumonia or acute gastroenteritis.1 An asymptomatic carrier state is also recognized.1,6 There have been recent reports of Whipple disease occurring in patients receiving anti-TNF-ฮฑ therapy.3,7 Treatment of the infection with appropriate antimicrobial agents may be complicated by IRIS in approximately 10% of patients.8โ11
911 Erythrasma