Synovial fluid and microscopic results from arthrocentesis and synovial biopsies for patients with Whipples disease
Arthrocentesis for patients with Whipple’s disease and arthritis usually reveals an inflammatory fluid with white blood cell (WBC) counts between 2000 and 30,000 cells/mm 3 with >50% of polymorphonuclear cells. Repeat arthrocentesis after antibiotic therapy shows resolution of inflammation, with WBC counts between 100 and 300 cells/mm 3 and <50% of polymorphonuclear cells. Synovial biopsy also demonstrates an inflammatory picture, with focal synovial lining cell hyperplasia and moderate perivascular lymphocytosis. Importantly, there are also PAS-positive granules in macrophages (foamy macrophages) within the synovial membrane, most likely representing degenerated bacterial forms.
