A case of aortic valve disease associated with Tropheryma whippelii infection in the absence of other signs of Whipple's disease

A case of endocarditis caused by Tropheryma whippelii is reported. The 69-y ear-old patient was diagnosed as suffering from severe aortic regurgitation requiring aortic valve replacement, but showed no other symptoms of Whippl e's disease, T. whippelii was detected in the explanted aortic valve by bro ad-range PCR amplification of the 165 rDNA and subsequent sequence analysis of the product. The etiologic agent was classified as a type 2A sequence v ariant based on the 16S-235 intergenic spacer and the 23S rDNA (domain III) sequences. The histological examination of the aortic valve was compatible with Whipple's disease. A duodenal biopsy revealed an infection with Giard ia lamblia, but T. whippelii and histological signs of Whipple's disease we re not detectable.