Whipple's disease: Is Tropheryma whippelii (Whipple's bacillus) foodborne?

摘要

Whipple's disease is a rare systemic disease with symptoms nominated by diarrhea, weight loss, arthralgia or arthritis and abdominal pain. Whipple's disease is limited to humans and the disease is caused by infection with the grampositive bacterium, Tropheryma whippelii. PCR determinations suggest that T. whippelii is an environmental actinomycete but studies on the organism have been limited due to the inability to culture the organism in vitro. Most patients are male Caucasians older than 50 years of age living in North and South America, England, continental Europe and Australia. The cellular immune system appears to control T. whippelii and patients with cellular immune defects appear to be more susceptible to Whipple's disease. The disease affects the gastrointestinal tract, the central nervous system, cardiovascular system and musculoskeletal system; however, other organs also may be affected Whipple's disease can be treated with antibiotics effective against gram-positive bacteria but relapses are common. Untreated Whipple's disease is usually fatal. Although the mode of transmission of T. whippelii in humans is unclear, it possibly occurs through the fecal-oral route and food and/or water may be the source of the organism.