A 30 year old male presented with insidious onset of diarrhea, steatorrhea, abdominal pain, weight loss, migratory large joint ahropathy, fever and dementia. The most probable diagnosis is:
Whipple's disease is a chronic multisystem disease caused by tropheryma whipplei bacteria. Dementia is a late symptom. Diagnosed by PAS positive macrophages in small intestinal biopsy. DOC is double strength trimethoprim / sulfamethoxazole. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2479
Chronic calcific pancreatitis
Whipple's disease
Tropical sprue
Celiac sprue