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Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis

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Abstract

Introduction

Many clinical manifestations can be related to Tropheryma whipplei infection.

Case report

We report a Tropheryma whipplei limbic encephalitis developed as a relapse of classical Whipple’s disease.

Discussion

This case is to the best of our knowledge the first proof of the effective brain–blood barrier crossing of both doxycycline and hydroxychloroquine as demonstrated by direct concentration monitoring on brain biopsy.

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Acknowledgements

We thank the patient for participating. We also thank Pr. Ph. FERNANDEZ for brain 18F-FDG-PET picture, and Dr. Pantxika BELLECAVE, for technical assistance.

Author information

Authors and Affiliations

  1. Service de médecine interne et pathologies infectieuses, CHU de Bordeaux, Groupe Hospitalier Saint André, hôpital Saint André, 1 rue Jean Burguet, 33000, Bordeaux Cedex, France

    Didier Brönnimann

  2. Service de maladies infectieuses et dermatologie, Centre hospitalier de la côte basque, 64100, Bayonne, France

    Marc-Olivier Vareil

  3. CHU Bordeaux, Unité Neurovasculaire, 33000, Bordeaux, France

    Igor Sibon

  4. Univ. Bordeaux, INCIA UMR CNRS 5287, 33000, Bordeaux, France

    Igor Sibon

  5. Aix Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM 1095, 13000, Marseille, France

    Jean-Christophe Lagier, Hubert Lepidi & Didier Raoult

  6. Service des pathologies infectieuses et tropicales, CHU de Bordeaux, hôpital Pellegrin, 33000, Bordeaux, France

    Mathilde Puges, Fatiha Haneche, Arnaud Desclaux, Didier Neau & Charles Cazanave

  7. Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et à chlamydiae, 33000, Bordeaux, France

    Charles Cazanave

Authors
  1. Didier Brönnimann
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  2. Marc-Olivier Vareil
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  3. Igor Sibon
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  4. Jean-Christophe Lagier
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  5. Hubert Lepidi
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  6. Mathilde Puges
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  7. Fatiha Haneche
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  8. Didier Raoult
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  9. Arnaud Desclaux
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  10. Didier Neau
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  11. Charles Cazanave
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Contributions

Dr. DB and Pr. CC had full access to all the data in the study and takes responsibility for the integrity of the data. Study concept and design: DB, IS, DN, CC. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: BB, CC, AD. Critical revision of the manuscript for important intellectual content: DB, IS, JL, HL, DR, DN, CC. Administrative, technical, or material support: DB, MP, FH. Study supervision: CC.

Corresponding author

Correspondence to Didier Brönnimann.

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The authors declare that they have no conflict of interest.

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Brönnimann, D., Vareil, MO., Sibon, I. et al. Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis. Infection 47, 637–641 (2019). https://doi.org/10.1007/s15010-018-1173-x

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  • DOI: https://doi.org/10.1007/s15010-018-1173-x

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