Rare multisystem disorder with malabsorption, lymphadenopathy and arthritis.
Caused by an infection by Tropheryma whippelii, an acti-nomycete. The route of infection is unknown. The organism is found in intestinal macrophages.
Patients present with steatorrhoea, abdominal pain and systemic symptoms of fever, weight loss, lymphadenopathy and arthritis. Heart, lung and CNS involvement may occur.
Electron microscopy can demonstrate the organism. PCR is now available for diagnosis. Various antibiotics are used often in combination and for prolonged courses (up to 1 year).