WHIPPLES-DISEASE - A DIFFICULT DIAGNOSIS

We present 3 patients with Whipple's disease all characterized by a lo ngstanding prodromal period with progressive weight loss, diarrhoea, l ymphadenitis and arthralgia or arthritis. Sarcoid-like Whipple's disea se was diagnosed in one patient. He was treated with antibiotics. Init ially his condition improved; however, a cerebral relapse developed wh ich was treated successfully by ceftriaxone and cefixime. Extraintesti nal Whipple's disease (lymph node localisation) was diagnosed in anoth er patient treated successfully with antibiotics. A third case of Whip ple's disease was unexpectedly diagnosed by laparotomy and partial sma ll bowel resection. He was not treated till 2 years later with tetracy cline. After 1 year of treatment his condition had improved.