Format

Send to

Choose Destination
JAMA. 2001 Feb 28;285(8):1039-43.

Culture and immunological detection of Tropheryma whippelii from the duodenum of a patient with Whipple disease.

Author information

1
Unité des Rickettsies, Faculté de Médecine, Université des la Méditerranée/CNRS, 27 Boulevard Jean Moulin, UPRESA 6020, 13385 Marseille CEDEX 05, France. Didier.Raoult@medecine.unive-mrs.fr

Abstract

CONTEXT:

Culture of Tropheryma whippelii has been established only once, in human fibroblast cell lines from a heart valve inoculum. Molecular-based diagnostic techniques, although highly sensitive, may be less specific. New diagnostic tools involving isolation of bacteria from contaminated intestinal biopsies and immunohistological detection need to be developed.

OBJECTIVE:

To describe a novel method for detection and culture of T whippelii strains.

DESIGN, SETTING, AND SUBJECTS:

Laboratory analysis of duodenal biopsy specimens from a patient with typical relapsing Whipple disease with intestinal involvement, performed Marseille, France, in March 2000. Biopsy specimens were decontaminated with antimicrobial agents and inoculated onto cell cultures. Mouse anti-T whippelii polyclonal antibodies were used to detect T whippelii in fixed specimens taken from the patient before and after relapse, compared with specimens from 10 controls. The genotype of the isolate was determined by amplification and sequencing of 2 DNA fragments (ITS and 23S rRNA).

MAIN OUTCOME MEASURE:

Isolation and genotyping of a new strain(s) of T whippelii from the case patient's biopsy specimens.

RESULTS:

A strain was grown from the case patient's intestinal specimen that has a genotype different from the first strain isolated. During 2 episodes of Whipple disease, T whippelii bacteria were detected by immunochemistry in the patient's duodenal biopsy specimens, but not in controls.

CONCLUSIONS:

A second strain of T whippelii has been isolated and a protocol for isolation from the intestine has been proven to be efficient. Immunodetection of T whippelii in intestinal biopsy specimens may provide a useful tool for the diagnosis and follow-up of patients with Whipple disease. Both techniques need further evaluation and confirmation.

PMID:
11209175
DOI:
10.1001/jama.285.8.1039
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center