Cardiac valves in patients with whipple endocarditis: Microbiological, molecular, quantitative histologic, and immunohistochemical studies of 5 patients

Hubert Lepidi, Florence Fenollar, J. Stephen Dumler, Valérie Gauduchon, Lara Chalabreysse, Antoine Bammert, Marie France Bonzi, Françoise Thivolet-Béjui, François Vandenesch, Didier Raoult

Research output: Contribution to journalArticlepeer-review

Abstract

The pathological features of Whipple endocarditis, which is caused by Tropheryma whipplei, were histologically evaluated in cardiac valves from 5 patients. We used quantitative image analysis to compare the valvular fibrosis, calcifications, vegetations, inflammation, and vascularization due to Whipple endocarditis with those due to non-Whipple endocarditis and degenerative valves. We also studied the presence of T. whipplei in valves by immunohistochemical analysis, culture, and polymerase chain reaction (PCR). In histologic analysis, Whipple endocarditis was characterized by significant fibrosis, a lack of calcifications, slight inflammation and vascularization, and vegetations of intermediate size. Inflammatory infiltrates consisted mainly of foamy macrophages and lymphocytes. We found that the detection of T. whipplei in cardiac valves, by immunohistochemical analysis, was correlated with the detection of the bacterium by culture and PCR. We report, for the first time, the immunodetection of T. whipplei in a surgically removed arterial embolus. Pathological and immunohistologic analyses may contribute to the diagnosis of Whipple endocarditis.

Original languageEnglish (US)
Pages (from-to)935-945
Number of pages11
JournalJournal of Infectious Diseases
Volume190
Issue number5
DOIs
StatePublished - Sep 1 2004

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Cardiac valves in patients with whipple endocarditis: Microbiological, molecular, quantitative histologic, and immunohistochemical studies of 5 patients'. Together they form a unique fingerprint.

Cite this