Case ReportA rare presentation of hypovolemic shock secondary to Whipple’s diseaseTandon, Parula; Huang, Viviana; Jaffer, Nasirb; Kirsch, Richardc; Croitoru, KennethaAuthor Information aDepartment of Medicine, Division of Gastroenterology, Mount Sinai Hospital, University of Toronto bDepartment of Medical Imaging cDepartment of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada Correspondence to Kenneth Croitoru, MDCM, FRCPC, Division of Gastroenterology, Mount Sinai Hospital, Room 437 600 University Avenue, Toronto, ON, Canada M5G 1×5 Tel: +1 416 586 4800 x7454; fax: +1 416 586 4747; e-mail: firstname.lastname@example.org European Journal of Gastroenterology & Hepatology: May 2019 - Volume 31 - Issue 5 - p 642-645 doi: 10.1097/MEG.0000000000001363 Buy Metrics Abstract Whipple’s disease is a rare, multisystem infection caused by the Gram-positive Tropheryma whippelii organism. In addition to neurological and rheumatological manifestations, this disease can result in significant gastrointestinal symptoms such as malabsorption, diarrhea, and weight loss. Given the diagnostic challenge and rare occurrence, a high index of suspicion is critical to prevent morbidity and mortality from this otherwise highly infectious disease transmitted via the fecal-oral route. We present a very rare but near-fatal case of hypovolemic shock secondary to protein-losing enteropathy and gastrointestinal bleeding from small bowel T. whippelii infection. Furthermore, the epidemiology, clinical presentation, diagnosis, and management of Whipple’s disease is reviewed. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.