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Tropheryma whipplei

Tropheryma whipplei is a Gram-positive, aerobic rod-shaped bacterium from the Cellulomonadaceae family.

Tropheryma whipplei can cause a very rare multi-systemic disease called Whipple’s disease. Disease symptoms include:

  • Arthralgia (joint pain)

  • Diarrhea

  • Abdominal pain

  • Malabsorption syndrome

  • Gaze palsy

  • Endocarditis (inflammation of the heart’s inner lining)

Tropheryma whipplei is widespread in the environment, e.g., in wastewater. Regionally, antibodies to the pathogen are detectable in up to 70% of the population. The rarity of disease is due to the fact that Whipple’s disease only occurs when there is a defect in cellular immunity.

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Low

  • Pulmonology: Not relevant

  • Ear, nose, and throat: Not relevant

  • Urology: Not relevant

Relevance for endoscope surveillance

  • Low or moderate concern organism

Transmission route

Transmission is presumed to be fecal-oral and via contaminated water.

Resistance to antibiotics

Resistance to fluoroquinolones is described.

Further readings

  1. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  2. Lagier JC et al. Systemic Tropheryma whipplei: clinical presentation of 142 patients with infections diagnosed or confirmed in a reference center, Medicine (Baltimore), 2010 Sep;89(5):337–345.

  3. La Scola B et al. Can Whipple's disease be transmitted by gastroscopes? Infect Control Hosp Epidemiol. 2003 Mar;24(3):191–4.

  4. Muscarella LF Is gastrointestinal endoscopy a risk factor for Whipple's disease? Infect Control Hosp Epidemiol. 2004 Jun;25(6):453–4 author reply 455.

  5. Sanchez E/Eberhard M Heilbare chronische Arthritis? – Morbus Whipple! 06. Oktober 2016,  https://www.universimed.com/ch/article/rheumatologie/heilbare-chronische-arthritis-morbus-whipple-2097450 (accessed on 07.16.2021).