Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis
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Many clinical manifestations can be related to Tropheryma whipplei infection.
We report a Tropheryma whipplei limbic encephalitis developed as a relapse of classical Whipple’s disease.
This case is to the best of our knowledge the first proof of the effective brain–blood barrier crossing of both doxycycline and hydroxychloroquine as demonstrated by direct concentration monitoring on brain biopsy.
KeywordsTropheryma whipplei Whipple’s disease Limbic encephalitis Emerging infectious disease
We thank the patient for participating. We also thank Pr. Ph. FERNANDEZ for brain 18F-FDG-PET picture, and Dr. Pantxika BELLECAVE, for technical assistance.
Dr. DB and Pr. CC had full access to all the data in the study and takes responsibility for the integrity of the data. Study concept and design: DB, IS, DN, CC. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: BB, CC, AD. Critical revision of the manuscript for important intellectual content: DB, IS, JL, HL, DR, DN, CC. Administrative, technical, or material support: DB, MP, FH. Study supervision: CC.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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