Treatment

Untreated Whipple disease can be fatal. Systemic trimethoprim-sulfamethoxazole is the preferred treatment. Patients allergic to sulfonamides may be treated with ceftriaxone, tetracycline, or chloramphenicol. Treatment duration may vary from 1 to 3 months, but relapses occur in 30% of cases, necessitating prolonged (up to 1 year) treatment. Retinal vasculitis can resolve with treatment, but neurologic deficits become permanent.

• Nubourgh I, Vandergheynst F, Lefebvre P, Lemy A, Dumarey N, Decaux G. An atypical case of Whipple’s disease: case report and review of the literature. Acta Clin Belg. 2008;63(2):107–111.

• Touitou V, Fenollar F, Cassoux N, et al. Ocular Whipple’s disease: therapeutic strategy and long-term follow-up. Ophthalmology. 2012;119(7):1465–1469.

Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.