What is a typical clinical manifestation of Whipple disease?

Whipple disease is a systemic illness caused by the bacterium Tropheryma whipplei, leading to a range of clinical manifestations primarily due to malabsorption and damage to the intestines. One of the hallmark symptoms of this disease is chronic malabsorptive diarrhea. The malabsorption occurs because the infection leads to the infiltration of the intestinal lining with macrophages, which disrupts nutrient absorption and results in steatorrhea (fatty stools), weight loss, and other gastrointestinal disturbances.

Chronic malabsorptive diarrhea is typically characterized by frequent, oily, and foul-smelling stools due to undigested fats, which is the primary reason for the significant weight loss reported in affected individuals. This symptom often precedes other systemic findings, allowing clinicians to narrow down the differential diagnosis effectively.

In contrast, other options such as nausea and vomiting do not capture the essence of Whipple disease's gastrointestinal effects accurately, since the primary issue is malabsorption rather than obstructive symptoms. A hypoechoic pancreatic mass is more indicative of pancreatic abnormalities rather than the specific duodenal involvement seen in Whipple disease. Finally, diverticulitis relates to inflammation of diverticula in the colon and does not align with the infectious and malabsorptive