Klochan, ChristenAnderson, Teresa A.Rose, DustenDimitrov, Rosen K.Johnson, Raymond M.2016-06-152016-06-152013-10Klochan, C., Anderson, T. A., Rose, D., Dimitrov, R. K., & Johnson, R. M. (2013). Nearly Fatal Case of Whipple’s Disease in a Patient Mistakenly on Anti-TNF Therapy. ACG Case Reports Journal, 1(1), 25–28. http://doi.org/10.14309/crj.2013.112326-3253https://hdl.handle.net/1805/9988Whipple's disease is a rare cause of chronic diarrhea and abdominal pain that may be confused with inflammatory bowel disease. We report a Whipple's case misdiagnosed as Crohn's disease in which treatment with anti-tumor necrosis factor (anti-TNF) therapy led to nearly fatal progression. Lymph node tissue obtained during laparotomy for suspected bowel necrosis stained dramatically with periodic acid-Schiff (PAS), and electron microscopy showed a bacterium consistent with Trophyrema whipplei. The patient made a remarkable recovery complicated only by cholestatic hepatitis, which was likely a treatment-associated inflammatory response. This case serves as a reminder that all granulomatous infections should be considered prior to initiation of anti-TNF therapies.en-USAttribution 3.0 United StatesElectron MicroscopyHistoplasmaAnti-tumor Necrosis Factor TherapyWhipple’s DiseaseTropheryma whippleiArticle