SHM Converge Scientific Abstract ePoster Gallery-Ripples in the Heart

Pdf Summary

This case report describes Whipple’s endocarditis, a rare form of infective endocarditis caused by <em>Tropheryma whipplei</em>, typically affecting middle-aged men and often presenting as blood culture-negative disease. A 55-year-old man presented with worsening tremors, fever, myalgias, supraventricular tachycardia, elevated troponins, and a tender left inguinal lymph node. Cardiac evaluation revealed new moderate aortic insufficiency with a thickened, sclerotic aortic valve on transthoracic echocardiogram, and transesophageal echocardiogram showed a thickened echodensity concerning for vegetation. PCR testing was positive for <em>T. whipplei</em>, confirming the diagnosis.

The patient was treated with doxycycline and hydroxychloroquine for 12 months, with repeat PCR testing every six months. He became PCR-negative on four consecutive tests after treatment and remained well for seven years without relapse.

The discussion emphasizes that Whipple’s endocarditis is difficult to diagnose because it rarely meets Duke criteria and is often overlooked. Common cardiac manifestations include heart failure, valvular disease, and peripheral arterial embolism. In this case, diagnosis was made earlier than typical—before arthralgia developed—thanks to PCR and echocardiographic findings. Early recognition and treatment were associated with a good long-term outcome and preserved quality of life.

The report concludes that prompt history taking, appropriate testing, and early therapy are essential because Whipple’s endocarditis carries significant mortality and relapse risk.

Asset Subtitle

Mathew A. Thomas

Meta Tag

Author List Dhruv Joshi, Mathew A. Thomas, Michael Anderson, Suchitra Muralidharan

Category Clinical Vignettes

Concept Whipple Endocarditis

Concept Infective Endocarditis

Concept Negative Culture Result

Concept Polymerase Chain Reaction

Concept Echocardiography

Distinguished Non-Finalist

Presenter Organization Riverside Medical Center

Presenting Author Mathew A. Thomas

Track Adult

Keywords

Whipple’s endocarditis

Tropheryma whipplei

infective endocarditis

blood culture-negative

aortic insufficiency

echocardiogram

PCR testing

doxycycline

hydroxychloroquine

valvular disease

Whipple Endocarditis

Infective Endocarditis

Negative Culture Result

Polymerase Chain Reaction

Echocardiography