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Treatment: Whipple disease requires treatment with antibiotics such as intravenous ceftriaxone or penicillins that can cross blood-brain barrier and achieve high levels in CSF. This is followed by prolonged therapy (1-2 years) with oral trimethoprim-sulfamethoxazole (TMP-SMX) or cotrimoxazole.
The disease used to be universally fatal in the pre-antibiotic era. Despite successes with antibiotic therapy, relapses occur in 17% to 35% of cases. CNS symptoms may persist after treatment.
The image shows aggregates of foamy macrophages surrounding cystic spaces in a mesenteric lymph node in Whipple disease.
The disease used to be universally fatal in the pre-antibiotic era. Despite successes with antibiotic therapy, relapses occur in 17% to 35% of cases. CNS symptoms may persist after treatment.
The image shows aggregates of foamy macrophages surrounding cystic spaces in a mesenteric lymph node in Whipple disease.