%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Lagier, J. C.
%A Fenollar, F.
%A Koric, L.
%A Guedj, E.
%A Ceccaldi, M.
%A Raoult, Didier
%T Weight loss, dementia and ataxia susceptible to doxycycline : a likely new case report caused by T. whipplei
%D 2013
%L PAR00011184
%G ENG
%J Revue de Medecine Interne
%@ 0248-8663
%K Tropheryma whipplei ; Whipple's disease ; Doxycyclin ; (18)FDG-PET
%M ISI:000326433200009
%N 10
%P 641-644
%R 10.1016/j.revmed.2012.12.006
%U https://www.documentation.ird.fr/hor/PAR00011184
%V 34
%W Horizon (IRD)
%X 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.
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