The Diagnosis of Whipple's Disease

Whipple's disease is both rare and enigmatic. It usually presents in middle-aged men, but in the 80 or so years since it was first described, fewer than 10 cases per year have been reported in the world's literature.1 The most common clinical presentation is a malabsorption syndrome, although patients may have severe arthralgias for years before diarrhea develops. Cardiac and central nervous system involvement is also common. Patients may present with fever of undetermined cause, a sarcoidosis-like illness, or a wasting syndrome. Because the illness is insidious in its onset, has a varied clinical presentation, and is rare, it is . . .