Cor Vasa 2025, 67(Suppl.3):12-16 | DOI: 10.33678/cor.2025.028

(Infective endocarditis with an atypical causative agent Tropheryma whipplei or Whipple's endocarditis)

Kristýna Tůmová, Marek Šebo, Petr Fila, Petr Němec

Centrum kardiovaskulární a transplantační chirurgie Brno, Česká republika

Infective endocarditis (IE) is an inflammatory disease of the endocardium, most commonly caused by pathogens such as Staphylococcus spp., Streptococcus spp., and Enterococcus spp. However, in some cases, the causative organisms are difficult to culture, resulting in blood culture-negative endocarditis (BCNE). One of the rare pathogens associated with BCNE is Tropheryma whipplei, the bacterium responsible for Whipple's disease. When T. whipplei infects the endocardium without other systemic manifestations, the condition is referred to as Whipple's endocarditis. Tropheryma whipplei is a rare cause of IE that often presents with atypical clinical features and persistently negative blood cultures. This case report underscores the crucial role of polymerase chain reaction (PCR) in establishing the diagnosis in patients with suspected IE and repeatedly negative blood cultures. Given the diagnostic complexity and often subtle clinical presentation, the true incidence of Whipple's endocarditis is likely underestimated.

Keywords: Actinomyces, Infective endocarditis, Ruptured spleen, Tropheryma whipplei, Whipple's disease

Received: January 3, 2025; Revised: February 16, 2025; Accepted: February 16, 2025; Prepublished online: June 2, 2012; Published: September 1, 2025  Show citation