[Dementia in Whipple's disease?: relevance of infectious etiologies].

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.