K90.81

Clinical Causes: Infection with the bacterium Tropheryma whipplei Possible environmental exposure to contaminated water, soil, or food Potential genetic susceptibility factors Transmission through ingestion of contaminated material (although exact transmission pathways are not fully understood)

Key Symptoms: Chronic weight loss Diarrhea and steatorrhea (fatty stools) Abdominal pain and cramping Fevers and chills Joint pain and swelling Muscle aches Anemia or fatigue Swelling of lymph nodes Neurological symptoms such as confusion, memory issues, or personality changes Skin darkening or other dermatological signs

Diagnosis Path: Small intestine biopsy during endoscopy to identify characteristic macrophages containing Tropheryma whipplei Special staining techniques (Periodic acid–Schiff or PAS staining) to detect bacteria within tissue samples Polymerase Chain Reaction (PCR) testing to detect bacterial DNA Blood tests to evaluate anemia, nutrient deficiencies, or inflammatory markers Assessment of neurological function if neurological symptoms are present

Treatment Protocols: Initial course of intravenous antibiotics such as ceftriaxone or penicillin for 2 weeks Followed by a long-term oral antibiotic regimen, often sulfamethoxazole-trimethoprim, for 12 months or longer Supportive care for nutritional deficiencies and symptom management Monitoring for relapse or persistent symptoms through regular follow-up