What causes Whipple disease

etiologic factors of Whipple disease and how is the diagnosis made? 

Whipple disease is caused by a gram-positive actinomycete called Tropheryma whipplei. The diagnosis is made by demonstrating periodic acid–Schiff (PAS)-positive inclusions in macrophages of affected tissues, typically a small bowel or lymph node biopsy sample. These deposits contain the rod-shaped free Tropheryma whipplei bacilli seen on electron microscopy. The diagnosis can be confirmed by a polymerase chain reaction (PCR) of the DNA sequence of the 16S-ribosomal RNA gene sequence of T. whipplei in the PAS-positive tissue sample. PCR testing of cerebrospinal fluid has also been used to confirm central nervous system (CNS) Whipple disease. PCR testing of synovial fluid and blood can be performed but has limited sensitivity in patients with untreated Whipple disease.

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