, Volume 47, Issue 2, pp 317–321 | Cite as

Fluorescent in situ hybridization can be used as a complementary assay for the diagnosis of Tropheryma whipplei infection

  • Elsa Prudent
  • Guillaume Le Guenno
  • Stijn Jonckheere
  • Anne Vankeerberghen
  • Hubert Lepidi
  • Emmanouil AngelakisEmail author
  • Didier Raoult
Case Report



Immunohistochemistry and Periodic acid–Schiff (PAS) staining have been routinely used for the diagnosis of Whipple’s disease (WD). However, these methods present limitations. As a result, the last years, Fluorescence in situ hybridization (FISH) has been increasingly used as a complementary tool for the diagnosis of WD from various tissue samples.

Case report

In this study, we visualized, by FISH, Tropheryma whipplei within macrophages of a lymph node from a patient with WD. Moreover, we report in this study a patient with a pulmonary biopsy compatible with WD by PAS, immunostaining and FISH, although the specific molecular assays for T. whipplei were negative. Sequencing analysis of the 16S rDNA revealed a T. whipplei-related species with unknown classification.


FISH can be a valuable method for the detection of Tropheryma species in formalin-fixed paraffin-embedded tissues. FISH cannot replace the other already approved diagnostic techniques for WD, it can be used as a complementary tool and can provide supplementary information in a relatively short time.


Tropheryma whipplei Fluorescent in situ hybridization Lymphadenopathy Respiratory infection Whipple’s disease 



This study was supported by Méditerranée-Infection and the National Research Agency under the program “Investissements d’Avenir” reference ANR-10-IAHU-03. This study was approved by the Ethics Committee of the Mediterranée-Infection foundation under the number 2016-025.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics Committee of the Mediterranée Infection foundation under the number 2016-025.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Elsa Prudent
    • 1
  • Guillaume Le Guenno
    • 2
  • Stijn Jonckheere
    • 3
  • Anne Vankeerberghen
    • 3
  • Hubert Lepidi
    • 1
  • Emmanouil Angelakis
    • 4
    • 5
    Email author
  • Didier Raoult
    • 1
  1. 1.Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée InfectionMarseilleFrance
  2. 2.Department of Internal Medicine, Hôpital EstaingCentre, Hospitaliser UniversitaireClermont-FerrandFrance
  3. 3.Laboratory of Clinical MicrobiologyOLV Hospital AalstAalstBelgium
  4. 4.Aix Marseille Université, IRD, APHM, VITROME, IHU-Méditerranée InfectionMarseilleFrance
  5. 5.Laboratory of Medical MicrobiologyHellenic Pasteur InstituteAthensGreece

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