INSUBCONTINENT EXCLUSIVE:
A 51-year-old man showed up at a hospital in Germany looking as though he was wasting away, with swelling and tenderness in his ankles and
Then, his heart stopped.Doctors were able to resuscitate him
Then, they got to work trying to figure out what was wrong
The man told them that for three months he had been suffering from diarrhea, weight loss, joint pain, and fever
His case was reported in this week's issue of the New England Journal of Medicine.Blood tests didn't detect any infection, but imaging of
his heart told a different story
Doctors saw "vegetation" on both his aortic valve and mitral valve
Vegetations are clumps or masses that often build up from an infection, generally containing a bundle of proteins, platelets, and infecting
While they cause damage where they are, if they fully dislodge, they threaten to move to other parts of the body, such as the brain or
lungs, and cause dangerous blockages
In the man's case, the vegetation on his aortic valve appeared mobile.The man was quickly sent to emergency surgery to replace his valves
Once removed, the diseased valves were sent for testing to see what was in those dangerous masses
The result likely came as a surprise to the doctors.The man had in his heart Tropheryma whipplei, a very common environmental bacterium that
The condition affects about one to three people in a million, most often middle-aged Caucasian men, like the patient in this case
Overall, 85 percent of Whipple's disease cases are in men.So, how can such a common germ also cause such a rare infection? Researchers think
it's due to genetic predisposition and a glitch in immune responses
Many people likely get infected with T
whipplei as kids, and have either an asymptomatic or limited gastrointestinal infection
They then develop protective immune responses
But in the few people who develop Whipple's disease, this process seems to go awry
whipplei, but don't neutralize the germ
When this happens, the immune system doesn't generate protective antibodies against the bacterium, and inflammation ratchets up
This, in turn, leads to the development of a systemic infection.
