Ocular manifestations of Whipple disease: An atypical presentation

Jonathan G. Williams, Deepak P. Edward, Howard H. Tessler, David H. Persing, P. Shawn Mitchell, Debra A. Goldstein

Research output: Contribution to journalArticlepeer-review

Abstract

A 62-year-old man developed bilateral granulomatous iridocyclitis after uncomplicated cataract surgery. On ophthalmic examination, we found moderate inflammation in the anterior chamber and vitreous, with granular crystalline deposits on the iris, intraocular lens, and capsular bag. Biopsy of the lens capsule and vitreous revealed periodic acid-Schiff-positive, diastase- resistant bacilli consistent with Tropheryma whippelii. Electron microscopy and polymerase chain reaction confirmed the diagnosis of Whipple disease. A jejunal biopsy specimen also revealed T whippelii. Treatment with trimethoprim-sulfamethoxazole, cefixime, rifampin, and doxycycline resulted in improvement of systemic symptoms, but intraocular inflammation persisted. Intraocular inflammation was eventually reduced with the intravenous administration of ceftriaxone sodium.

Original languageEnglish (US)
Pages (from-to)1232-1234
Number of pages3
JournalArchives of Ophthalmology
Volume116
Issue number9
StatePublished - 1998
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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