Disease Information for Whipples CNS disease/encephalopathy

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Clinical Manifestations
Signs & Symptoms
Diarrhea and Weight Loss
Abnormal movements/involuntary
Central Facial Paralysis
Cognitive defect
Conjugate gaze paralysis
Drowsiness/somnolence
Facial weakness/droop, unilateral
Myoclonus/Myoclonic jerks on exam
Nystagmus
Nystagmus, pendular
Oculomasticatory myorhythmia/synchronous nystagmus-jaw
Progressive neurological disorder/signs
Rapidly progressive dementia
Rhythmic jaw movements
Ruminating Jaw Movements
Chronically ill patient/signs
Fatigue Tiredness in Elderly
Fevers, low grade/recurrent
Hypersomnia/Increased need for sleep
Difficulty Focusing Eyes
Diplopia Double vision
Double Image Vision Confirmed
Upward gaze paralysis/sign
Upward gaze paralysis/voluntary
Vertical gaze problems
True Vertigo Sign Confirmed
Clinical Presentation & Variations
Presentation/Dementia Myoclonus Progessive Age 60
Presentation/Dementia Upward Gaze Paralysis Myoclonus
AIDS with Fever
Disease Progression
Course/Chronic disorder
Course/Chronic only
Course/Potentially lethal/untreated
Course/Progressive/slowly chronic illness
Lethal Potential
Onset/insidious
Demographics & Risk Factors
Established Disease Population
Patient/AIDS established population
Patient/Whipples disease
Patient/Immune compromised/Immune suppressed
Population Group
Aged Adult
Man
Middle Age Adult
Sex & Age Groups
Population/Adult Aged Only
Population/Adult/all
Population/Elderly Aged
Population/Fifties adult
Population/Male
Population/Man patient
Population/Middle-aged adult
Population/Seventies Adult
Population/Sixties-adult
Laboratory Tests
Microbiology & Serology Findings
Microlab/PCR identification
Microlab/PCR Whipples/Tropherymia Whippelii RNA sequence
Microlab/PCR/Antigen test/Abnormal
Microlab/CSF PCR Tropherymia Whippelii
Microlab/CSF Polymerase chain reaction/PCR abnormal
Abnormal Lab Findings (Non Measured)
CSF abnormal
Abnormal Lab Findings - Increased
CSF Cells
CSF Centrifuged pellet/PAS positive
Diagnostic Test Results
Other Tests & Procedures
TEST/D-Xylose absorption abnormal
Pathology
BX/Duodenal biopsy PCR tropheryma whippelii
Associated Diseases & Rule outs
Associated Disease & Complications
CNS disease/involvement
Coma/Unconscious
Death Outcome
Dementia
Encephalopathy/CNS effect
Hemiparesis
Meningitis, chronic
Neurodevelopmental disorders
Neurologic side effects
Ophthalmoplegia
Psychosis
Intracranial Lesion
Parinaud's Ophthalmoplegia
Disease Mechanism & Classification
Specific Agent
AGENT/Bacteria (category)
AGENT/Gram positive bacillus/rods (ex)
AGENT/Non-motile bacteria (example)
Class
CLASS/Neurologic (category)
Pathophysiology
Pathophysiology/Granulomatous CNS/brain/cord
Pathophysiology/Secondary bacterial lesion infection
Process
PROCESS/INCIDENCE/Rare disease (ex)
PROCESS/Infection/agent specific (category)
Synonyms
Synonym
Disease Whipple, Disease Whipple's, Encephalopathies, encephalopathy, Encephalopathy not elsewhere classified, Encephalopathy unspecified, GRANULOMATOSIS LIPOPHAGIC INTESTINAL, intestinal lipodystrophy, Intestinal Whipple's disease, lipodystrophy intestinal, SPRUE NONTROPICAL SECONDARY, Unspecified encephalopathy, Unspecified encephalopathy (disorder), WD Whipple's disease, WHIPPLE DIS, Whipple Disease, WHIPPLES DIS, Whipples Disease, Whipple's Disease, Whipple's disease (disorder), Synonym/Whipple's encephalitis
Treatment
Drug Therapy - Indication
RX/Antibiotic/Combinations
RX/Antimicrobial medication/Prolonged treatment
RX/Penicillin
RX/Streptomycin (generic)
RX/Trimethoprim-sulfamethoxazole (Bactrim)
Definition

Whipple"s disease is a multi-system infectious bacterial disease that interferes with the body"s ability to metabolize fats; The disorder can affect any system in the body, including the central nervous system, but usually occurs in the gastrointestinal system; Gastrointestinal symptoms may include diarrhea, weight loss, fatigue, weakness, and abdominal bleeding and pain; Neurological symptoms may include abnormalities of eye and facial muscle movements, confusion, seizures, ataxia, memory loss, and vision impairment; Fever, cough, and joint soreness may also be present; The standard treatment for Whipple"s disease is a prolonged course of antibiotics; Untreated, Whipple"s disease is fatal;

----------[NINDS_com 2005]---------- Fever, lymphadenopathy, arthralgias; Weight loss, malabsorption, chronic diarrhea; Duodenal biopsy with periodic acid-Schiff (PAS)-positive macrophages with characteristic bacillus; Whipple"s disease is a rare multisystemic illness caused by infection with the bacillus Tropheryma whippelii; It may occur at any age but most commonly affects white men in the fourth to sixth decades; The source of infection is unknown, but no cases of human-to-human spread have been documented; The clinical manifestations are protean; Arthralgias or a migratory, nondeforming arthritis occurs in 80% and is typically the first symptom experienced; Gastrointestinal symptoms occur in approximately 75% of cases; They include abdominal pain, diarrhea, and some degree of malabsorption with distention, flatulence, and steatorrhea; Weight loss is the most common presenting symptom—seen in almost all patients-----------

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External Links Related to Whipples CNS disease/encephalopathy
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Wikipedia
Merck
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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