Whipple's disease complicated by a retinal Jarisch-Herxheimer reaction: a case report.

Schulenburg, E.; Herrington, C. Simon; Hodgson, H. J. F.

doi:10.1136/gut.33.1.132

Cited by 25 publications

(13 citation statements)

References 9 publications

(3 reference statements)

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“…Cutaneous manifestations of infection by C. jeikeium were described by Dan et al (100). More recently, AIDS with (413) and without (381) neutropenia, neutropenia (373), neoplasms (25,137), meningitis with transverse myelitis (217), cerebral ventriculitis (235), ventricular cerebrospinal fluid shunt infections (173), prosthetic and native heart valve endocarditis (432), osteomyelitis after total hip replacement (455), infectious arthritis after arthroplasty (465), and lymphadenopathy in a patient with Whipple's disease (339) have been reported as being associated with C. jeikeium infections. C. jeikeium was recently implicated as the cause of papular eruption with features histologically mimicking botryomycosis (220).…”

Section: Lipophilic Corynebacteriamentioning

confidence: 99%

Clinical microbiology of coryneform bacteria

et al. 1997

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Coryneform bacteria are aerobically growing, asporogenous, non-partially-acid-fast, gram-positive rods of irregular morphology. Within the last few years, there has been a massive increase in the number of publications related to all aspects of their clinical microbiology. Clinical microbiologists are often confronted with making identifications within this heterogeneous group as well as with considerations of the clinical significance of such isolates. This review provides comprehensive information on the identification of coryneform bacteria and outlines recent changes in taxonomy. The following genera are covered: Corynebacterium, Turicella, Arthrobacter, Brevibacterium, Dermabacter. Propionibacterium, Rothia, Exiguobacterium, Oerskovia, Cellulomonas, Sanguibacter, Microbacterium, Aureobacterium, "Corynebacterium aquaticum," Arcanobacterium, and Actinomyces. Case reports claiming disease associations of coryneform bacteria are critically reviewed. Minimal microbiological requirements for publications on disease associations of coryneform bacteria are proposed.

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Section: Lipophilic Corynebacteriamentioning

confidence: 99%

Clinical microbiology of coryneform bacteria

et al. 1997

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“…Isolated intraocular JHR has been previously reported in treatment of ocular syphilis with rapid visual loss [ 3 ]. Worsening after initial therapy has also been described in other conditions such as Whipple’s disease [ 4 ] and Lyme disease [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Paradoxical worsening of tuberculous chorioretinitis in a Chinese gentleman

Siantar

Agrawal

2015

J Ophthal Inflamm Infect

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We report a case of paradoxical worsening of tuberculous chorioretinitis after initiation of anti-tuberculous therapy (ATT). The patient had left panuveitis with tuberculous chorioretinitis and was started on systemic ATT and oral steroids a week later. However, he developed paradoxical worsening 2 months after initiation of therapy. He was continued on ATT, oral steroids and intravitreal amikacin with resolution of the chorioretinal lesion subsequently. Ocular tuberculosis often poses a diagnostic challenge, and clinicians should be aware of the possibility of paradoxical worsening despite appropriate ATT. Clinicians should strongly consider starting oral steroids concurrently with ATT when managing ocular tuberculosis.

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“…Furthermore, the hematogenous spread of T. whippelii to the brain may be reasonably expected to cause vasculitis of cerebral vessels, which, in turn, could result in a greatly increased risk of the patient suffering an ischemic or hemorrhagic infarction. Vasculitis has been described in patients with Whipple's disease involving the retina as a primary event as well as part of a Jarisch-Herxheimer reaction following antibiotic treatment, but so far this has not been reported elsewhere in the CNS [11,12].…”

Section: Commentmentioning

confidence: 93%

A patient with cerebral Whipple's disease and a stroke-like syndrome

Famularo

Minisola

Simone

2005

Scandinavian Journal of Gastroenterology

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The central nervous system (CNS) may be affected in up to 50% of patients with Whipple's disease and this can occur even with little or no gastrointestinal involvement. We describe a 63-year-old patient in whom CNS involvement with Whipple's disease had the clinical and imaging features of a brain infarction. Treatment with aspirin and ceftriaxone followed by trimethoprim-sulfamethoxazole resulted in a good neurological recovery and complete remission of the malabsorption syndrome. Cerebral Whipple's disease resembling a stroke syndrome has so far been reported in only two other patients and in both cases it represented the first presentation of the disease. Arterial or arteriolar fibrosis, thrombosis and thickening associated with the inflammation of adjacent brain parenchyma and leptomeninges, and cerebral vasculitis caused by the hematogenous spread of Tropheryma whippelii to the brain may all be important triggers of brain infarction in patients with Whipple's disease. Our case report highlights the important point that cerebral Whipple's disease with the features of a stroke syndrome, if recognized early and treated aggressively with antibiotics, could have a favorable course with no long-term disability sequelae.

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Whipple's disease complicated by a retinal Jarisch-Herxheimer reaction: a case report.

Cited by 25 publications

References 9 publications

Clinical microbiology of coryneform bacteria

Clinical microbiology of coryneform bacteria

Paradoxical worsening of tuberculous chorioretinitis in a Chinese gentleman

A patient with cerebral Whipple's disease and a stroke-like syndrome

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