Complications
Severe CNS infection with T whipplei may cause irreversible tissue damage, due either to the infection itself or to local inflammatory reactions of the host in response to the infection. Thus, persistent neurologic deficits reflect, in most cases, irreversible tissue damage and not persistent infection. However, the CSF of patients with CNS infection should be assessed regularly during the treatment by T whipplei-specific PCR to ensure that T whipplei is eradicated.
Long-lasting arthritis caused by T whipplei may lead to severe damage of the cartilage and the articular capsule. Because cartilage has very poor regenerative potential, tissue injury may persist even after successful eradication of T whipplei and arthritis may continue. Specific PCR and/or histology of synovial tissue should be used to ensure that T whipplei is eradicated.
More common in patients immunocompromised before the diagnosis.[18] Fever and nonspecific inflammation occur in the course of antibiotic treatment after an initial improvement of symptoms. Should be treated with anti-inflammatory drugs.
Tropheryma whipplei may cause culture-negative infective endocarditis.[15] Diagnosis is made after valve resection followed by molecular biologic or histologic exam of the resected material.
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