A 45-year-old Caucasian man is referred for further workup of chronic abdominal pain and diarrhea. These symptoms have been present for 2 months, and he has lost 10 kg of weight over this time. He also reports that he has developed pain in multiple joints that comes and goes and seems to spread from one joint to the next. He denies fevers, chills, chest pain, shortness of breath, vomiting, episodes of constipation, or hematochezia. He is married and works as a farmer, with no recent sick contacts or travel. His vitals are within normal limits, and his examination is unremarkable. A complete laboratory workup is unremarkable. He undergoes a colonoscopy, which is normal, and then undergoes an upper endoscopy. Biopsy of the small intestine shows many macrophages within the lamina propria that stain positive with periodic acid-Schiff (PAS). Which of the following is likely to cure this patient of his chronic diarrhea?Ask StudybuddyGroup of answer choicesCorticosteroidsAntibioticsRadioiodineDietary changesAntiretrovirals
Question
A 45-year-old Caucasian man is referred for further workup of chronic abdominal pain and diarrhea. These symptoms have been present for 2 months, and he has lost 10 kg of weight over this time. He also reports that he has developed pain in multiple joints that comes and goes and seems to spread from one joint to the next. He denies fevers, chills, chest pain, shortness of breath, vomiting, episodes of constipation, or hematochezia. He is married and works as a farmer, with no recent sick contacts or travel. His vitals are within normal limits, and his examination is unremarkable. A complete laboratory workup is unremarkable. He undergoes a colonoscopy, which is normal, and then undergoes an upper endoscopy. Biopsy of the small intestine shows many macrophages within the lamina propria that stain positive with periodic acid-Schiff (PAS). Which of the following is likely to cure this patient of his chronic diarrhea?Ask StudybuddyGroup of answer choicesCorticosteroidsAntibioticsRadioiodineDietary changesAntiretrovirals
Solution
The patient's symptoms and the biopsy results suggest that he may have Whipple's disease, a rare bacterial infection that affects multiple systems in the body. The bacteria interfere with normal digestion by disrupting the breakdown of foods, such as fats and carbohydrates, and hampering the body's ability to absorb nutrients.
The bacteria also can infect other parts of the body, including the heart, brain, and joints. The disease is caused by the bacterium Tropheryma whipplei.
The treatment of choice for Whipple's disease is antibiotics, which can eliminate the bacteria causing the infection. Therefore, the answer to the question "Which of the following is likely to cure this patient of his chronic diarrhea?" is Antibiotics.
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