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Article
Cultivation of Tropheryma whipplei from Cerebrospinal Fluid
Faculty Publications, Biological Sciences
  • Matthias Maiwald, Stanford University. School of Medicine
  • Axel von Herbay, University of Heidelberg. Dept. of Pathology
  • David N. Fredricks, Stanford University. School of Medicine
  • Cleber C. Ouverney, Stanford University. School of Medicine
  • Jon C. Kosek, Stanford University. School of Medicine & Veterans Affairs Palo Alto Health Care System
  • David A. Relman, Stanford University. School of Medicine & Veterans Affairs Palo Alto Health Care System
Document Type
Article
Publication Date
9-15-2003
DOI
10.1086/378073
Abstract

Whipple disease (WD) is a systemic disorder caused by the bacterium Tropheryma whipplei. Since the recognition of a bacterial etiology in 1961, many attempts have been made to cultivate this bacterium in vitro. It was eventually isolated, in 2000, from an infected heart valve, in coculture with human fibroblasts. Here we report the isolation of 2 new strains of T. whipplei from cerebrospinal fluid (CSF) of 2 patients with intestinal WD but no neurological signs or symptoms. One culture-positive specimen was obtained before treatment; the other was obtained 12 months after discontinuation of therapy, at a time of intestinal remission. In both cases, 15 passages of the cultures were completed over 17 months. Bacterial growth was measured by quantitative polymerase chain reaction, which suggested a generation time of 4 days. Staining with YO-PRO nucleic-acid dye showed characteristic rod-shaped bacteria arranged in chains. Fluorescent in situ hybridization with a T. whipplei–specific oligonucleotide probe, a broad-range bacterial probe, and a nonspecific nucleicacid stain indicated that all visible bacteria were T. whipplei. Scanning electron microscopy and transmission electron microscopy showed both intracellular and extracellular bacteria. This first isolation of T. whipplei from CSF provides clear evidence of viable bacteria in the central nervous system in individuals with WD, even after prolonged antibiotic therapy.

Comments

Published in Journal of Infectious Diseases (2003) 188: 801-808. © 2003 by the Infectious Diseases Society of America. http://www.journals.uchicago.edu/doi/pdf/10.1086/378073

At the time of publication Cleber Ouverney was not yet affiliated with San Jose State University.

Citation Information
Matthias Maiwald, Axel von Herbay, David N. Fredricks, Cleber C. Ouverney, et al.. "Cultivation of Tropheryma whipplei from Cerebrospinal Fluid" Vol. 188 (2003) p. 801 - 808
Available at: http://works.bepress.com/cleber_ouverney/2/