An uncommon cause of recurrent strokes - Tropheryma whippelii endocarditis

Background-Cardiac involvement in Whipple's disease is not an uncommon phen omenon in autopsies, but its clinical occurrence is often overshadowed by g astrointestinal symptoms. We report a very atypical manifestation of this d isorder. Summary of Report - An extraordinary presentation of an extremely long-last ing, culture-negative endocarditis caused by Tropheryma whippelii is descri bed, the clinical consequence of which has become apparent in recurrent str okes. Conclusions-Cardiac involvement of Whipple's disease should always be consi dered in culture and serologically negative endocarditis. The polymerase ch ain reaction technique may be a useful tool to confirm a presumed diagnosis of T whippelii endocarditis and consequently to apply an effective treatme nt regimen.