{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T03:50:47Z","timestamp":1774842647328,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Orphanet J Rare Dis"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>We report a patient who presented with inflammatory back pain due to multisegmental spondylitis. Following a vertebral biopsy which failed to detect an infectious organism, the patient was treated with etanercept, a tumor necrosis factor (TNF)-\u03b1 inhibitor, for suspected undifferentiated spondyloarthritis. The back pain worsened and the spondylitic lesions increased. Only in a vertebral rebiopsy with polymerase chain reaction (PCR) amplification of <jats:italic>Tropheryma whipplei<\/jats:italic>, the causative agent of Whipple's disease was identified. <jats:italic>Tropheryma whipplei<\/jats:italic> should be considered as a cause of spondylitis even with multisegmental involvement and in the absence of gastrointestinal symptoms. In this clinical setting, routine PCR for <jats:italic>Tropheryma whipplei<\/jats:italic> from vertebral biopsies is recommended.<\/jats:p>","DOI":"10.1186\/1750-1172-4-13","type":"journal-article","created":{"date-parts":[[2009,6,3]],"date-time":"2009-06-03T18:24:04Z","timestamp":1244053444000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Multisegmental spondylitis due to Tropheryma whipplei: Case report"],"prefix":"10.1186","volume":"4","author":[{"given":"David","family":"Spoerl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"B\u00e4r","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Vogt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Tyndall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich A","family":"Walker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2009,6,3]]},"reference":[{"key":"147_CR1","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1002\/art.21619","volume":"54","author":"M Rudwaleit","year":"2006","unstructured":"Rudwaleit M, Metter A, Listing J, Sieper J, Braun J: Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. 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