Table 1 Summary of all reported cases of Whipple’s disease with ophthalmic manifestations
Case report | Gender | Age | Ocular/Orbital Manifestations | Systemic Manifestations (at Diagnosis) | Relapse | Treatment | Ocular Histopathology |
|---|---|---|---|---|---|---|---|
Lieger et al. (2007) [9] | Male | 61 | Proptosis, periorbital edema, pain, limitation of ocular movements, Low visual acuity, chemosis, conjunctival hyperemia, RAPD | Arthralgia, constitutional symptoms | Positive | Oral Trimethoprim-sulfamethoxazole 160/800 mg BID (Co-Trimoxazole), I.V Ceftriaxone 2 g/day, I.V metronidazole 3 × 500/day, oral prednisolone, orbit surgical decompression performed) | Yes- Pas positive intracytoplasmic particles, |
Huerva et al. (2008) [8] | Female | 63 | Proptosis, pain, limitation of ocular movements, conjunctival hyperemia, retinal hemorrhages | Chronic, Diarrhea, Arthralgias, constitutional symptoms. | Positive | I.V ceftriaxone, trimethoprim 160 mg-sulfamethoxazole 800 mg BID + Oral prednisolone | Yes - negative |
Parkash et al. (2017) [14] | Female | 38 | Diplopia, Myositis | Arthralgias, rash, constitutional symptoms, abdominal pain, diarrhea, severe pneumonia and altered consciousness | Positive | I.V Ceftriaxone 2 g/day, Oral Co-Trimoxazole 960 mg BID, Oral Doxycycline 200 mg/day, hydroxychloroquine 300 mg/day, Oral prednisolone | Yes- Immunohistochemistry: positive staining of the macrophages with an antibody to T. whipplei |
Testi et al. (2018) [13] | Patient 1: Male | 35 | Chronic bilateral keratoconjunctivitis | Abdominal pain, diarrhea, and progressive weight loss | Positive | Doxycycline 200 mg/day, hydroxychloroquine 200 mg TID/day, Oral | None |
Patient 2: Female | 32 | bilateral vitritis | Abdominal pain and swelling | None | cotrimoxazole 160/800 mg BID, ceftriaxone 2 g/day. | None | |
Patient 3: Male | 63 | chronic bilateral panuveitis | Gait unbalance, mild dysarthria, and arthralgias | None | cotrimoxazole 160/800 mg BID, Doxycycline 200 mg/day, hydroxychloroquine 200 mg TID/day | Yes- diagnostic vitrectomy: positive PCR for T.whipplei DNA | |
Kanikunnel et al. (2020) [12] | Male | 49 | Unilateral optic nerve edema | None | Positive | Systemic antibiotic | None |
Alsarhani et al. (2020) [11] | Patient 1: Male | 60 | Scleral nodule | none | none | Topical antibiotics, Prednisolone acetate drops | Yes- Intracytoplasmic organisms within foamy macrophages |
Patient 2: Male | 53 | Scleral nodules | None | None | Topical antibiotics, Prednisolone acetate drops | Yes- Intracytoplasmic organisms within foamy macrophages | |
Bosello et al. (2021) [10] | Male | 53 | Bilateral blurred vision, cystoid macular edema, optic disc edema, Roth spots. | None | None | Oral Prednisolone, Adalimumab, I.V ceftriaxone 2 g/day, doxycycline 100 mg BID. Pars plana Vitrectomy (PPV) + cataract surgery OU | None |
Sampaio et al. (2022) [7] | Female | 59 | Proptosis, periorbital edema, limitation of ocular movements, conjunctival injection | Diarrhea, constitutional symptoms, adenopathy, pulmonary inflammation. | Positive | Doxycycline 100 mg bid, cotrimoxazole 160/800 mg BID, I.V ceftriaxone 2 g/day Oral prednisolone | None |
Asiri et al. (current case) | Male | 38 | Swelling of the left upper eyelid | None | None | Evacuation | Yes- Intracytoplasmic organisms within foamy macrophages |