Whipple's disease Tropheryma whippelii

• Facts:
  Multi-system infection by gram positive bacillus T. whippelii
• History / PE:
  Gastrointestinal symptoms
  Chronic malabsorptive diarrhea (steatorrhea, flatulence)
  Abdominal pain
  Protein-losing enteropathy
  
  Extraintestinal manifestations
  Migratory non-deforming arthritis
  Chronic cough
  Myocardial or valvular involvement
  Lymphadenopathy
  Low grade fever
  
  Later disease stages
  Dementia
  Supranuclear ophthaloplegia
  Myoclonus
• Diagnosis:
  Small intestinal biopsy shows PAS positive macrophages