{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:49:32Z","timestamp":1792648172642,"version":"4.5.0"},"reference-count":14,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1992,1]]},"abstract":"<jats:p>A 36 year old white man was diagnosed as having Whipple's disease after a prolonged illness of lethargy, night sweats, and weight loss associated with lymphadenopathy and splenomegaly. Biopsy specimen of an inguinal lymph node confirmed the presence of periodic acid Schiff positive macrophages and culture gave a pure growth of Corynebacterium jeikeium. Twelve hours after the introduction of oral co-trimoxazole and streptomycin the patient's condition deteriorated. He became confused, feverish, and developed florid retinal vasculitis with associated visual impairment. Both the systemic symptoms and the retinal vasculitis responded to treatment with corticosteroids and his vision returned to normal. We think this was a Jarisch-Herxheimer reaction not previously described in Whipple's disease and advise inspection of the fundi of such patients before starting treatment.<\/jats:p>","DOI":"10.1136\/gut.33.1.132","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"132-134","source":"Crossref","is-referenced-by-count":23,"title":["Whipple's disease complicated by a retinal Jarisch-Herxheimer reaction: a case report."],"prefix":"10.1136","volume":"33","author":[{"given":"R J","family":"Playford","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Schulenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C S","family":"Herrington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J","family":"Hodgson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1992,1,1]]},"reference":[{"issue":"18","key":"ref_1","first-page":"382","article-title":"A hitherto undescribed disease characterised anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues","volume":"1907","author":"Whipple, G.H.","unstructured":"Whipple GH. A hitherto undescribed disease characterised anatomically by deposits of fat and fatty acids in the intestinal and mesenteric lymphatic tissues. Johns Hopkins MedJ 1907; 18: 382-91.","journal-title":"Johns Hopkins MedJ"},{"key":"ref_2","first-page":"307","article-title":"Whipple's disease: etiopathogenesis, treatment, diagnosis and clinical course. Case report and review of the world literature","volume":"21","author":"Misckhe, L.W.; Bluncke, S.; Fitsche, D.; Kuchemann, K.; Schuler, H.W.; Grozinger, K.H.","year":"1974","unstructured":"Misckhe LW, Bluncke S, Fitsche D, Kuchemann K, Schuler HW, Grozinger KH. Whipple's disease: etiopathogenesis, treatment, diagnosis and clinical course. Case report and review of the world literature. Acta Hepato-Gastroenterol 1974; 21: 307-26.","journal-title":"Acta Hepato-Gastroenterol"},{"key":"ref_3","first-page":"225","article-title":"Tinctoral demonstration of glycoprotein","volume-title":"Whipple's disease. Proc Soc Exp Biol Med 1949","volume":"72","author":"Black-Schaffer, B.","unstructured":"Black-Schaffer B. Tinctoral demonstration of glycoprotein in Whipple's disease. Proc Soc Exp Biol Med 1949; 72: 225-7."},{"key":"ref_4","first-page":"247","article-title":"Is there an immune deficit in whipple's disease?","volume":"26","author":"Dobbins, W.O.","year":"1981","unstructured":"Dobbins WO. Is there an immune deficit in whipple's disease? DigDisSci 1981; 26: 247-52.","journal-title":"DigDisSci"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/BF00957912","article-title":"Whipple's disease: A review of the literature and report of fifteen patients","volume":"336","author":"Enzinger, F.M.; Helwig, E.B.","year":"1963","unstructured":"Enzinger FM, Helwig EB. Whipple's disease: A review of the literature and report of fifteen patients. Virchows Arch (Pathol Anat) 1963; 336: 238-69.","journal-title":"Virchows Arch (Pathol Anat)"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/0016-5085(86)90398-7","article-title":"Whipple's disease with unusual clinical, bacteriologic, and immunologic findings","volume":"90","author":"Gupta, S.; Pinching, A.J.; Onwubalili, J.; Vince, A.; Evans, D.J.; Hodgson, H.J.F.","year":"1986","unstructured":"Gupta S, Pinching AJ, Onwubalili J, Vince A, Evans DJ, Hodgson HJF. Whipple's disease with unusual clinical, bacteriologic, and immunologic findings. Gastroenterology 1986; 90:1286-9.","journal-title":"Gastroenterology"},{"key":"ref_7","first-page":"1457","article-title":"Trois cas de maladie de Whipple","volume":"39","author":"Caroli, J.; Julien, C.; Eteve, J.; Prevot, A.R.; Sebald, M.","year":"1963","unstructured":"Caroli J, Julien C, Eteve J, Prevot AR, Sebald M. Trois cas de maladie de Whipple. Sem Hop Paris 1963; 39: 1457-80.","journal-title":"Sem Hop Paris"},{"key":"ref_8","first-page":"399","article-title":"Atypical bacteria in Whipple's disease","volume":"79","author":"Charache, P.; Bayless, T.M.; Shelley, W.M.","year":"1966","unstructured":"Charache P, Bayless TM, Shelley WM, et al. Atypical bacteria in Whipple's disease. Trans Assoc Am Physicians 1966; 79: 399-408.","journal-title":"Trans Assoc Am Physicians"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1159\/000198017","article-title":"Etiopathogenic studies in a patient with Whipple's disease","volume":"15","author":"Tytgat, G.N.; Hoogendijk, J.; Agenant, D.; Th, Schellekens P.","year":"1977","unstructured":"Tytgat GN, Hoogendijk J, Agenant D, Schellekens P Th. Etiopathogenic studies in a patient with Whipple's disease. Digestion 1977; 15: 309-21.","journal-title":"Digestion"},{"key":"ref_10","article-title":"Principles ofBacteriology virology and immunity","author":"Parker, M.J.","unstructured":"Parker MJ, Coller LH, eds. Principles ofBacteriology virology and immunity. 8th ed. London: Edward Arnold, 1990: 76.","edition":"8th ed"},{"key":"ref_11","first-page":"335","article-title":"Ocular findings in Whipple's disease","volume":"71","author":"Leland, T.M.; Chambers, J.K.","year":"1978","unstructured":"Leland TM, Chambers JK. Ocular findings in Whipple's disease. South Med3r 1978; 71: 335-8."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1001\/archopht.1984.01040030302024","article-title":"Manifestations ofWhipple's disease in the posterior segment of the eye","volume":"102","author":"Avila, M.P.; Jalkh, A.E.; Feldman, E.; Trempe, C.L.; Schepens, C.L.","year":"1984","unstructured":"Avila MP, Jalkh AE, Feldman E, Trempe CL, Schepens CL. Manifestations ofWhipple's disease in the posterior segment of the eye. Arch Opthalmol 1984; 102: 384-90.","journal-title":"Arch Opthalmol"},{"key":"ref_13","first-page":"1431","article-title":"Ocular involvement in Whipple's disease: Light and electronic microscopic observation","volume":"%:","author":"Font, R.L.; Rao, N.A.; Issarescu, S.; McEntee, W.J.","year":"1978","unstructured":"Font RL, Rao NA, Issarescu S, McEntee WJ. Ocular involvement in Whipple's disease: Light and electronic microscopic observation. Arch Ophthalmol 1978; %: 1431-6.","journal-title":"Arch Ophthalmol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1056\/NEJM197607222950409","article-title":"Endotoxaemia associated with the Jarisch herxheimer reaction","volume":"295","author":"Gelfand, J.A.; Elin, R.J.; Berry, F.W.; Frank, M.M.","year":"1976","unstructured":"Gelfand JA, Elin RJ, Berry FW, Frank MM. Endotoxaemia associated with the Jarisch herxheimer reaction. N Engl J Med 1976; 295: 211-3.","journal-title":"N Engl J Med"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.33.1.132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T10:37:34Z","timestamp":1765622254000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.33.1.132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,1]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1992,1,1]]},"published-print":{"date-parts":[[1992,1]]}},"alternative-id":["10.1136\/gut.33.1.132"],"URL":"https:\/\/doi.org\/10.1136\/gut.33.1.132","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,1]]}}}