A rare case of Whipple disease presenting as a hydrosalpinx and granulomatous peritonitis

Authors

  • Milan Dokic Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade, Serbia
  • Tijana P Janjic Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade, Serbia
  • Aleksandra B Beleslin Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade, Serbia https://orcid.org/0000-0002-2407-8975
  • Jelena D Micic Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade, Serbia
  • Ljubisa Z Jovanovic Department of Pathology and Medical Cytology, University Clinical Center of Serbia, Belgrade, Serbia
  • Jasna Jovic Department for Gastroenterology, Military Medical Academy, Belgrade, Serbia https://orcid.org/0000-0002-3343-0395

DOI:

https://doi.org/10.3855/jidc.17984

Keywords:

Whipple disease, granulomatous salpingitis, antibiotics

Abstract

Introduction: Whipple disease is a rare infectious disease caused by the bacterium Tropheryma whipplei. The classic form affects gastrointestinal and musculoskeletal systems; but other forms may damage the heart, brain, or lungs. Due to non-specific and diverse clinical symptoms, diagnosis of Whipple disease is challenging and often late. Adequate and timely antibiotic treatment is essential for favorable outcome.

Case presentation: Here we present a case of a young woman admitted to the gynecological clinic for diagnostic laparoscopy for suspected haemato-/hydro- salpinx and peritoneal endometriosis. Macroscopic findings during laparoscopy revealed miliary whitish lesions in the pelvis and histopathology reported granulomatous salpingitis and peritonitis. She was complaining of intermittent abdominal pain, bloating and weight loss. Subsequently, the laparoscopy symptoms worsened and her general condition deteriorated. Differential diagnosis included infective agents such as Mycobacterium tuberculosis; in addition to sarcoidosis, granulomatosis with polyangiitis, and malignancies; all of which were excluded. Finally, Tropheryma whipplei was suspected, and after esophagogastroduodenoscopy with duodenal biopsy, long-term antibiotic treatment was initiated and the patient fully recovered.

Conclusions: Although Whipple disease is rare, it is important to have a high level of awareness for Tropheryma whipplei infection. The localization and course of Whipple’s disease may be unpredictable, but a favorable outcome is expected with adequate antibiotic treatment.

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Published

2024-08-31

How to Cite

1.
Dokic M, Janjic TP, Beleslin AB, Micic JD, Jovanovic LZ, Jovic J (2024) A rare case of Whipple disease presenting as a hydrosalpinx and granulomatous peritonitis. J Infect Dev Ctries 18:1308–1312. doi: 10.3855/jidc.17984

Issue

Section

Case Reports