Oral Doxycycline Plus Low-dose Hydroxychloroquine Following Intravenous Ceftriaxone may be Effective for Whipple's Disease in Japan : A Case Report and Literature Review.

A 52-year-old woman presented with weight loss and fever of unknown origin that had persisted for one year. She presented with multiple lymphadenopathies, primarily within the abdominal cavity, but no joint symptoms were observed. A second upper endoscopy revealed diffuse white shaggy villi in the duodenum and the ileum. A definitive diagnosis of Whipple's disease was made based on electron microscopy and polymerase chain reaction (PCR) of the biopsy specimen. Treatment was initiated with doxycycline plus low-dose hydroxychloroquine oral therapy, followed by ceftriaxone intravenous infusion. Ten months after treatment, the patient responded successfully with no side effects.