Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review

Abstract Background Whipple’s disease, caused by Tropheryma whipplei, is a rare chronic infection predominantly affecting the gastrointestinal tract. Ocular involvement is uncommon, and periorbital manifestations are exceedingly rare. This case report highlights a unique presentation of Whipple’s di...

Full description

Saved in:
Bibliographic Details
Main Authors: Ashwaq Yahya Asiri, Khawlah A. Alzaben, Yousef A. AlOtaibi, Humoud Mohammad AlOtaibi, Hind Manaa Alkatan
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Ophthalmology
Subjects:
Online Access:https://doi.org/10.1186/s12886-025-03902-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849761718071197696
author Ashwaq Yahya Asiri
Khawlah A. Alzaben
Yousef A. AlOtaibi
Humoud Mohammad AlOtaibi
Hind Manaa Alkatan
author_facet Ashwaq Yahya Asiri
Khawlah A. Alzaben
Yousef A. AlOtaibi
Humoud Mohammad AlOtaibi
Hind Manaa Alkatan
author_sort Ashwaq Yahya Asiri
collection DOAJ
description Abstract Background Whipple’s disease, caused by Tropheryma whipplei, is a rare chronic infection predominantly affecting the gastrointestinal tract. Ocular involvement is uncommon, and periorbital manifestations are exceedingly rare. This case report highlights a unique presentation of Whipple’s disease as an eyelid abscess in a patient with type 1 diabetes mellitus. Case presentation A 38-year-old male with poorly controlled type 1 diabetes mellitus presented with a two-weeks history of progressive swelling in the left upper eyelid. The swelling initially appeared three months prior and was associated with mild pain. Clinical examination revealed a large, erythematous, bluish, and non-tender swelling in the left upper eyelid, causing mechanical ptosis. Additional lesions were noted on the scalp and abdomen. Imaging showed a well-circumscribed fluid-filled lesion in the left upper eyelid. A tissue sample was taken for culture and biopsy during surgical drainage. The histopathology showed foamy macrophages with Diastase-resistant intracytoplasmic organisms that were further demonstrated by Gram stain confirming the diagnosis of Whipple’s disease. Conclusion This case illustrates a rare presentation of Whipple’s disease manifesting as an eyelid abscess in a diabetic patient. The diagnosis was confirmed through histopathological examination, emphasizing the importance of considering Whipple’s disease in the differential diagnosis of atypical ocular presentations.
format Article
id doaj-art-ca920775f80d44008c8130ef25dfc5db
institution DOAJ
issn 1471-2415
language English
publishDate 2025-03-01
publisher BMC
record_format Article
series BMC Ophthalmology
spelling doaj-art-ca920775f80d44008c8130ef25dfc5db2025-08-20T03:05:56ZengBMCBMC Ophthalmology1471-24152025-03-012511610.1186/s12886-025-03902-6Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature reviewAshwaq Yahya Asiri0Khawlah A. Alzaben1Yousef A. AlOtaibi2Humoud Mohammad AlOtaibi3Hind Manaa Alkatan4Department of Ophthalmology, College of Medicine, King Khalid UniversityKing Khaled Eye Specialist HospitalOphthalmology Division, Department of surgery, College of Medicine, Bisha UniversityKing Khaled Eye Specialist HospitalDepartments of Ophthalmology and Pathology, College of Medicine, King Saud UniversityAbstract Background Whipple’s disease, caused by Tropheryma whipplei, is a rare chronic infection predominantly affecting the gastrointestinal tract. Ocular involvement is uncommon, and periorbital manifestations are exceedingly rare. This case report highlights a unique presentation of Whipple’s disease as an eyelid abscess in a patient with type 1 diabetes mellitus. Case presentation A 38-year-old male with poorly controlled type 1 diabetes mellitus presented with a two-weeks history of progressive swelling in the left upper eyelid. The swelling initially appeared three months prior and was associated with mild pain. Clinical examination revealed a large, erythematous, bluish, and non-tender swelling in the left upper eyelid, causing mechanical ptosis. Additional lesions were noted on the scalp and abdomen. Imaging showed a well-circumscribed fluid-filled lesion in the left upper eyelid. A tissue sample was taken for culture and biopsy during surgical drainage. The histopathology showed foamy macrophages with Diastase-resistant intracytoplasmic organisms that were further demonstrated by Gram stain confirming the diagnosis of Whipple’s disease. Conclusion This case illustrates a rare presentation of Whipple’s disease manifesting as an eyelid abscess in a diabetic patient. The diagnosis was confirmed through histopathological examination, emphasizing the importance of considering Whipple’s disease in the differential diagnosis of atypical ocular presentations.https://doi.org/10.1186/s12886-025-03902-6Whipple's diseaseTropheryma whippleiEyelid abscessOcularDiabetes mellitus
spellingShingle Ashwaq Yahya Asiri
Khawlah A. Alzaben
Yousef A. AlOtaibi
Humoud Mohammad AlOtaibi
Hind Manaa Alkatan
Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review
BMC Ophthalmology
Whipple's disease
Tropheryma whipplei
Eyelid abscess
Ocular
Diabetes mellitus
title Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review
title_full Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review
title_fullStr Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review
title_full_unstemmed Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review
title_short Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review
title_sort eyelid abscess as an initial manifestation of whipple s disease a case report and comprehensive literature review
topic Whipple's disease
Tropheryma whipplei
Eyelid abscess
Ocular
Diabetes mellitus
url https://doi.org/10.1186/s12886-025-03902-6
work_keys_str_mv AT ashwaqyahyaasiri eyelidabscessasaninitialmanifestationofwhipplesdiseaseacasereportandcomprehensiveliteraturereview
AT khawlahaalzaben eyelidabscessasaninitialmanifestationofwhipplesdiseaseacasereportandcomprehensiveliteraturereview
AT yousefaalotaibi eyelidabscessasaninitialmanifestationofwhipplesdiseaseacasereportandcomprehensiveliteraturereview
AT humoudmohammadalotaibi eyelidabscessasaninitialmanifestationofwhipplesdiseaseacasereportandcomprehensiveliteraturereview
AT hindmanaaalkatan eyelidabscessasaninitialmanifestationofwhipplesdiseaseacasereportandcomprehensiveliteraturereview