Whipple's disease classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Whipple’s disease may be classified into 4 groups based on clinical manifestation: Acute infection, asymptomatic carrier state, the classic Whipple’s disease, and localized chronic infection.

Classification

• Whipple's disease may be classified to 2 groups of acute and chronic based on the duration.
• Whipple's disease may be classified to 2 groups of systemic and localized infection based on organ involvement.
• Tropheryma whipplei infection may be classified to 4 groups based on the clinical manifestation:
  • Acute infections such as:
    • Gastroenteritis
    • Bacteremia
    • Pneumonia
  • Asymptomatic carrier state
  • The classic Whipple’s disease
  • Localized involvement of different organs including:
    • Heart:
      • Blood-culture negative endocarditis
      • Adhesive pericarditis
      • Myocardial fibrosis
    • CNS:
      • Encephalitis
      • Progressive dementia
      • Cerebellar ataxia
      • Personality changes
      • Hemiparesis
      • Seizure
      • Wernicke’s encephalopathy
      • Hypothalamic involvement
      • Supranuclear ophthalmoplegia
    • Eyes:
    • Lung:
    • Bone:
    • Serosa:
    • Skin:

Whipple's disease classification based on the duration

Whipple's disease classification                                                                                                                           Acute               Chronic                                                                                                                           Gastroenteritis   Pneumonia   Bacteremia   Asymptomatic carrier state     Classic Whipple's disease                                                                                                     Chronic localized infection

Whipple's disease classification based on organ involvement

Whipple's disease classification                                                                                                                                                                 Systemic involvement                           Localized involvement                                                                                                                                                                               Heart   CNS   Eye   Lung   Bone   Serosa   Skin                                                                                             • Blood-culture negative endocarditis • Adhesive pericarditis • Myocardial fibrosis   • Encephalitis • Progressive dementia • Cerebellar ataxia • Personality changes • Hemiparesis • Seizure • Wernicke’s encephalopathy • Hypothalamic involvement • Supranuclear ophthalmoplegia   • Uveitis • Vitritis • Retinitis • Retrobulbar neuritis • Papilledema   • Chronic cough • Dyspnea   • Arthritis • Spondylodiscitis   • Pleuritic chest pain   • Hyperpigmentation