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Kjetil Taskén, MD, PhD; Tom Schulz, MD, PhD; Kjell Elgjo, MD, PhD; Kari Skullerud, MD, PhD; David Relman, MD; Oddbjørn Brubakk, MD, PhD

Arch Intern Med. 1998;158:801-803.

We describe 2 patients with a diagnosis of Whipple disease in whom the usual antibiotic therapy failed. A polymerase chain reaction–based test was used to identify the recently described Whipple bacillus, Tropheryma whippelii. In one case, the diagnosis was confirmed, whereas in the second case, which had been histologically diagnosed as Whipple disease of the brain, the process was identified as a monocyte-derived histiocytosis. In conclusion, Whipple disease can be distinguished from other diseases with similar histological features with the use of a polymerase chain reaction–based test.

From the Department of Medicine, Østfold Sentralsykehus, Sarpsborg, Norway (Drs Taskén and Brubakk); the Department of Medicine, Aust-Agder Sentralsykehus, Arendal, Norway (Dr Schulz); the Department of Pathology, The National Hospital (Drs Elgjo and Skullerud), and the Institute of Medical Biochemistry, University of Oslo (Dr Taskén), Oslo, Norway; the Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif (Dr Relman); and the Departments of Medicine and Microbiology and Immunology, Stanford University School of Medicine, Stanford, Calif (Dr Relman).

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