Lymph nodes & spleen, nonlymphoid
Lymph nodes-infectious / parasitic disorders
Whipple disease

Topic Completed: 1 June 2006

Minor changes: 14 August 2020

Copyright: 2003-2020,, Inc.

PubMed Search: Whipple disease lymph nodes

Page views in 2019: 948
Page views in 2020 to date: 929
Cite this page: DePond W. Whipple disease. website. Accessed October 28th, 2020.
Definition / general
  • Rare; due to infection by Tropheryma whipplei, present in soil and sewage but not animals
  • Typically affects farmers and outdoor workers
  • Symptoms include diarrhea, malabsorption, weight loss, fever, arthralgias; also occasional CNS and cardiac involvement
  • May cause marked enlargement of mesenteric and periaortic lymph nodes; enlargement of peripheral lymph nodes may occur early
  • Diagnosis requires massive involvement of node plus intense PAS+ staining (small aggregates of PAS+ macrophages are nonspecific) or PCR
  • Gram stain: gram+ bacteria
Case reports
  • IV penicillin and streptomycin or third generalization cephalosporin for 10 - 14 days, plus cotrimoxazone for 1 year
Microscopic (histologic) description
  • Nodal architecture obscured by ill defined lipogranulomas
  • Involvement of sinuses by macrophages with foamy cytoplasm
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick

Various images

PAS stain

Warthin-Starry stain

Positive stains
Negative stains
Electron microscopy description
  • Rod-like organisms
Electron microscopy images

Images hosted on other servers:

Trilaminar cell wall

Molecular / cytogenetics description
Differential diagnosis
Back to top
Image 01 Image 02