Joint pain is a common presenting symptom seen
in the outpatient setting. Accurate diagnosis is imperative for providing
optimal patient care. Our patient is a 50 year old male who presented with many
years of joint pain affecting multiple joints.
He was diagnosed with seronegative Rheumatoid
arthritis. Despite treatment with immunosuppressive medications, his joint
symptoms persisted
and he developed abdominal pain and diarrhoea. In light of these
gastrointestinal manifestations, his diagnosis was changed to Chron’s disease,
and his medications were modified.
Yet, his joint and abdominal symptoms remained
unremitted; hence he underwent further investigations which led to the
diagnosis of Whipple’s disease co-infected with Clostridium difficile. To the
author’s knowledge co-infection of Whipple’s disease with Clostridium difficile
has not been previously reported.
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