Blood Culture-negative Endocarditis Caused by Tropheryma whipplei: Whipple's endocarditis

Silke Knol; Rogier L Nijhuis; Felix Geeraedts; Gerard Cm Linssen

doi:10.12890/2021_002596

Blood Culture-negative Endocarditis Caused by Tropheryma whipplei: Whipple's endocarditis

Eur J Case Rep Intern Med. 2021 May 19;8(5):002596. doi: 10.12890/2021_002596. eCollection 2021.

Authors

Silke Knol¹, Rogier L Nijhuis¹, Felix Geeraedts², Gerard Cm Linssen¹

Affiliations

¹ Department of Cardiology, Hospital Group Twente (ZGT), Almelo and Hengelo, The Netherlands.
² Laboratory Microbiology Twente Achterhoek (LabMicTA), Hengelo, The Netherlands.

Abstract

Case description: A 67-year-old man was admitted with progressive heart failure due to blood culture-negative endocarditis of the aortic valve. Urgent aortic valve replacement was needed. Polymerase chain reaction (PCR) testing of samples of the explanted aortic valve revealed Tropheryma whipplei. The patient received ceftriaxone, followed by long-term co-trimoxazole. Recent arthralgia may have been a diagnostic clue.

Conclusion: Whipple's endocarditis should be considered in patients with arthralgia and blood culture-negative endocarditis (BCNIE).

Learning points: Whipple's endocarditis should be considered in patients with symptoms of arthralgia and blood culture-negative endocarditis (BCNIE).Serum polymerase chain reaction is the main diagnostic test.Both physician awareness and multidisciplinary management by regional endocarditis teams are recommended strategies to provide optimal patient care.

Keywords: Tropheryma whipplei; Whipple’s endocarditis; blood culture-negative endocarditis.