Neuropsychiatric manifestations Of Whipple disease in an adolescent: Case report.

Abstract

Whipple disease (WD) is a rare chronic systemic infection caused by the actinomycete Tropheryma Whipplei. The clinical manifestations are mainly intestinal, although occasionally  may present extraintestinal locations (joints, heart, pulmonary, central nervous system…) , and even the last can be the only symptom.

We present a 15-year-old female patient referred to the psychiatry service, with a diagnosis of depression, with a 6-month evolution with worsening, admission due to autolytic attempt and, at the same time, atypical neurological symptomatology. She is referred to Neurology to rule out organic pathology, including autoimmune pathologies (antiNMDA encephalitis, …), finding in the  study, PCR positive Tropheryma Whipplei, and being diagnosed of Whipple disease with neurological involvement. Antibiotic treatment was performed according to the established guidelines, repeated at the end of the treatment the lumbar puncture, resulting this negative and with clinical neurological improvement  as well as psychiatric.