20th July 2023

A 56-year-old man presents to an urgent care centre with a 2-year history of intermittent generalised abdominal discomfort

A 56-year-old man presents to an urgent care centre with a 2-year history of intermittent generalised abdominal discomfort associated with loose stools and 15kg of unintentional weight loss. He is otherwise well with no past medical history, no regular medications and no known drug allergies. Clinical examination reveals non tender inguinal lymphadenopathy and some mild generalised abdominal pain. Examination of the respiratory, neurological and cardiac systems are unremarkable. He undergoes a 2-week wait OGD and colonoscopy. Duodenal biopsies confirm a diagnosis of Whipple’s disease.

What is the most appropriate first line treatment?

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