Lagier J. C., Fenollar F., Koric L., Guedj E., Ceccaldi M., Raoult Didier. (2013). Weight loss, dementia and ataxia susceptible to doxycycline : a likely new case report caused by T. whipplei. Revue de Medecine Interne, 34 (10), p. 641-644. ISSN 0248-8663.
Titre du document
Weight loss, dementia and ataxia susceptible to doxycycline : a likely new case report caused by T. whipplei
Lagier J. C., Fenollar F., Koric L., Guedj E., Ceccaldi M., Raoult Didier
Source
Revue de Medecine Interne, 2013,
34 (10), p. 641-644 ISSN 0248-8663
Introduction. - Whipple's disease is a rare infectious disease due to Tropheryma whipplei, a bacterium rarely causing severe localized neurological infection (only 25 cases reported in the literature), which are more often diagnosed by a positive T. whipplei PCR performed on cerebrospinal fluid. Case report. - We report the third case of progressive dementia associated with obesity and ataxia in a 52-year-old man. Classic laboratory results performed to identify the etiology of the clinical features were non-contributive: only a saliva T. whipplei PCR was strongly positive and the Western blot serology has detected an asymptomatic carriage profile. The (18)FDG-PET highlighted a frontal area hypometabolism. An antibiotic treatment by doxycycline allowed a partial regression of the neurological manifestations, a weight loss and a significant improvement of the (18)FDG frontal hypometabolism. Conclusion. - Progressive dementia associated with ataxia and obesity is a new clinical syndrome caused by T. whipplei. Antibiotic test by doxycycline can help to the diagnosis and (18)-FDG could facilitate the follow-up.
