Infection with the bacteria Tropheryma whipplei.

- Very rare, mainly males 30-60 years of age

Clinical features:- Malabsorption syndrome, abdominal pain- Enteropathic arthritis (60% of cases), sacroiliitis (40% of cases)- Fever- Cardiac symptoms (e.g., valve insufficiencies)- Neurological conditions (myoclonia, ataxia, impairment of oculomotor function)

Diagnostics:- Small intestine biopsies: detection of PAS-positive macrophages- PCR testing and immunohistochemistry staining- If neurological complaints occur → liquor diagnostics, potentially MRI

Treatment:- IV ceftriaxone for 2 weeks- Maintenance treatment with oral trimethoprim-sulfamethoxazole for 1 year