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Meningo-Ependymitis in Whipple's Disease

Published online by Cambridge University Press:  18 September 2015

L.R. Lapointe ,
J. Lamarche ,
A. Salloum  and
R. Beaudry
L.R. Lapointe
Affiliation:
Departments of Medicine and Pathology, Centre Hospitalier Universitaire de Sherbrooke, Edmonton, Sherbrooke, P.Q
J. Lamarche
Affiliation:
Departments of Medicine and Pathology, Centre Hospitalier Universitaire de Sherbrooke, Edmonton, Sherbrooke, P.Q
A. Salloum
Affiliation:
Departments of Medicine and Pathology, Centre Hospitalier Universitaire de Sherbrooke, Edmonton, Sherbrooke, P.Q
R. Beaudry
Affiliation:
Departments of Medicine and Pathology, Centre Hospitalier Universitaire de Sherbrooke, Edmonton, Sherbrooke, P.Q
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Six years after apparent complete recovery from intestinal Whipple's disease, a 56 year old man developed insidious progressive somnolence and gait ataxia. Studies showed hydrocephalus with obstruction of the aqueduct and CSF leukocytosis and elevated protein. Arachnoid biopsy during craniotomy revealed chronic inflammatory infiltration with PAS-positive macrophages. The patient died 5 years later despite two courses of antibiotic therapy. This is the first report of histologically confirmed cerebral Whippie's disease during life.

Whipple's disease is a systemic infectious disorder. Cerebral involvement even in neurologically asymptomatic patients should be sought with periodic CSF cytologic studies and a search for hydrocephalus. The possibility of cerebral Whipple's disease should be considered in the presence of unexplained hydrocephalus and/or chronic inflammatory changes in the spinal fluid, especially in those with past or active intestinal disease.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 7 , Issue 2 , May 1980 , pp. 163 - 167
Copyright
Copyright © Canadian Neurological Sciences Federation 1980

References

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