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Background <p>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.</p> Case presentation <p>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.</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月6日

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  • Ashwaq Yahya Asiri,
  • Khawlah A. Alzaben,
  • Yousef A. AlOtaibi,
  • Humoud Mohammad AlOtaibi,
  • Hind Manaa Alkatan

摘要

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.