CEREBRAL RELAPSE OF SARCOID-LIKE WHIPPLES-DISEASE

Whipple's disease, an infection with the recently identified intracell ular bacillus Tropheryma whippelii, is a systemic disorder that can be life threatening when untreated. In a few patients, the signs and sym ptoms of the disease are similar to those of sarcoidosis, and this ill ness is referred to as sarcoidlike Whipple's disease. This variant mus t be recognized because patients with sarcoidlike Whipple's disease mu st be treated with antibiotics instead of corticosteroids, which would be indicated for patients with true sarcoidosis. We describe a 53-yea r-old man who had sarcoidlike Whippie's disease with polyvisceral gran ulomatous dissemination that was treated with procaine penicillin G an d streptomycin followed by doxycycline. His condition initially improv ed. However, during his 4-month course of treatment he developed a cer ebral relapse; this relapse was successfully treated with ceftriaxone and cefixime.