Diagnosis of Whipple's Disease by Molecular Analysis of Peripheral Blood

Whipple's disease is a systemic infection characterized most commonly by fever, weight loss, diarrhea, polyarthritis, and adenopathy1,2. Attempts to culture the causative organism have been unsuccessful, but microscopical examination of infected tissue, usually small-bowel-biopsy specimens or lymph nodes, reveals small gram-positive rods that appear as diastase-resistant intracytoplasmic inclusions on periodic acid-Schiff staining2. Electron microscopy reveals that these organisms possess a trilamellar membrane external to the cell wall, a finding usually associated with gram-negative bacteria3,4. Recent studies have shown that the specific identification of bacterial pathogens does not require culture but can be accomplished by molecular . . .