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.
Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.
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.
La Scola B et al. Can Whipple's disease be transmitted by gastroscopes? Infect Control Hosp Epidemiol. 2003 Mar;24(3):191–4.
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.
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).