[Dementia in Whipple's disease?: relevance of infectious etiologies]. / Demenz bei Morbus Whipple? Die Bedeutung infektiöser Krankheitsursachen.

HISTORY AND CLINICAL FINDINGS: A 69-year old patient who had been treated for joint pain over a long time was admitted because of weight loss and dementia. He was confused and cachectic with edema and skin hyperpigmentation. INVESTIGATIONS: Laboratory findings indicated chronic infection. Duodenal biopsy revealed Whipple's disease. The PCR of cerebrospinal fluid for Tropheryma whipplei was negative. TREATMENT AND COURSE: During treatment with ceftriaxon and intravenous fluid therapy the patient's mental state improved. However his motoric state remained insufficient. CONCLUSION: Whipple's disease should be considered in dementia, even more in previous "rheumatic symptoms", in order to avoid ineffective (immunosuppressive) treatment with unfortunate consequences.