Abstrakt

A case of community acquired Clostridium difficile and Tropheryma whipplei coinfection causing persistent joint pain

Krati Chauhan

Joint pain is a common presenting symptom seen in the outpatient setting. Accurate diagnosis is imperative for providing optimal patient care. Our patient is a 50 year old male who presented with many years of joint pain affecting multiple joints. He was diagnosed with seronegative Rheumatoid arthritis. Despite treatment with immunosuppressive medications, his joint symptoms persisted and he developed abdominal pain and diarrhoea. In light of these gastrointestinal manifestations, his diagnosis was changed to Chron’s disease, and his medications were modified. Yet, his joint and abdominal symptoms remained unremitted; hence he underwent further investigations which led to the diagnosis of Whipple’s disease co-infected with Clostridium difficile. To the author’s knowledge co-infection of Whipple’s disease with Clostridium difficile has not been previously reported. Community acquired Clostridium difficile infection has been a growing health concern. It can co-infect with other pathogens, confounding the clinical picture.