Panuveitis in Whipple´s Disease
Vehr S.1, Nestler A.1, Schütz A.2, Halm U.3, Meier P.1
1Klinik und Poliklinik für Augenheilkunde, 2Institut für Pathologie, Universität Leipzig
3Park-Krankenhaus Leipzig-Südost GmbH, Leipzig
Purpose: Whipple´s disease is a rare chronic infection with a bacterium named Tropheryma whipplei, that can involve any organ system and primarily occurs over several years in middle-aged males. Most common complaints in patients with Whipple´s disease are abdominal pain, diarrhea, weight loss, seizures, dementia, ataxia, hyper- and insomnia. Ocular manifestation can include uveitis, vitritis, retinitis, myositis, papilledema and optic atrophy.
Method: We report a case of a 45 year-old man, who complained of a progressive loss of vision R. Visual acuity R= 0,05; L= 0,8. Furthermore he suffered from a nonspecific rheumatic disease accompanied by pleural effusion and restrictive ventilation dysfunction until 1998, treated with steroids. The diagnosed bilateral uveitis intermedia R>L was treated with increased systemic and local steroids. Moreover an internal checkup was recommended. In the gastrointestinal examination duodenal biopsy could identify whipple´s disease. Despite of specific antibiotic therapy the follow-up examination showed increased inflammatory activity with panuveitis R>L and bilateral cataracta complicata. Visual acuity R=0,05; L= 0,3. Diagnostic pars plana vitrectomy with removal of an epiretinal membrane and cataract-operation was done on th
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