Abstract
BACKGROUND: Culture-negative endocarditis due to Tropheryma whipplei is a rare disease. Mostly the diagnosis is made by histologic examination of resected heart valve tissue. CASE PRESENTATION: In this case report, we described a patient with a classical Whipple's disease. Transesophageal echocardiography (TEE) showed a vegetation on noncoronary cusp of the aortic valve. Whipple's disease was confirmed by positive Tropheryma whipplei polymerase chain reaction (PCR) in EDTA blood and a duodenal biopsy with positive periodic acid-Schiff stain (PAS) macrophages. CONCLUSION: Due to timely diagnosis, our patient was treated with antibiotics without valve replacement.