A 55-year-old man with a 3-month history of chronic diarrhea and 12-lb weight loss presents with migratory arthralgias and progressive confusion. Vital signs show BP 128/76, HR 92, RR 18, Temp 37.8°C, SpO2 98% on room air. Labs reveal hemoglobin 11.2 g/dL. Endoscopy with small-bowel biopsy demonstrates foamy macrophages in the lamina propria that stain positive with periodic acid-Schiff. Chest imaging shows no lymphadenopathy. Which organism is most likely responsible?
- A)Giardia lamblia
- B)Tropheryma whippleiGABARITO
- C)Vibrio cholerae
- D)Clostridioides difficile
- E)Yersinia enterocolitica
Explicação
Whipple disease is caused by Tropheryma whipplei and classically presents with diarrhea, weight loss, arthralgias, and sometimes neurologic manifestations. PAS-positive foamy macrophages in the lamina propria are highly characteristic. Ver explicação completa e trilha adaptativa →