Whipple's disease and Tropheryma whippelii: Secrets slowly revealed

Whipple's disease was described in 1907 and was designated "intestinal lipo dystrophy," despite the detection of bacteria in 1 specimen. This finding w as later substantiated by the success of antibiotic therapy, which resulted in dramatic clinical responses, and by use of electron microscopy, which d etected monomorphic bacilli in affected tissues. Many attempts at culture f ailed, and these bacteria were characterized as actinomycetes for the first time by means of broad-range 16S rDNA amplification and molecular phylogen etic methods. The name "Tropheryma whippelii" was proposed for this bacteri um. Whipple's disease is a systemic disease that affects many organ systems , producing protean manifestations. This article summarizes recent developm ents with regard to this topic as well as unanswered questions regarding th e pathogenesis and acquisition of infection, the biology and ecology of the organism, the clinical spectrum of disease, diagnosis of the disease, and therapy.