Médecine thérapeutique / Pédiatrie
MENUTropheryma whipplei in childhood Volume 15, issue 2, Avril-Mai-Juin 2012
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- Key words: Whipple's disease, Tropheryma whipplei, gastroenteritis, pneumonia
- DOI : 10.1684/mtp.2012.0430
- Page(s) : 133-41
- Published in: 2012
Tropheryma whipplei is the bacterial infectious agent of Whipple's disease. The isolation of the first strain of T. whipplei has allowed the development of diagnostic tools, including molecular biology techniques that have been a capital contribution to a better characterization of the bacterium. The primo-infection appears probably in the childhood as acute infections (gastroenteritis, pneumopathy and/or bacteremia). Then, a cure is observed in most of the cases; a chronic carriage, mainly in stool specimens, is possible with a variable prevalence depending of geographical area. In rare cases, chronic infections will develop during adulthood among specific hosts. Among them, we observe the classic Whipple's disease characterized by a histological involvement and also localized chronic infection represented mainly by endocarditis, neurological involvement or uveitis. Strong beam of arguments suggests the existence of specific inherited immunodeficiencies associated with these chronic infections. Classic Whipple's disease requires antibiotic treatment in the long-term, but currently no specific treatment is available for carriage and acute infections, especially in children.