Diagnosis of Tropheryma whipplei pneumonia in an immunocompromised lymphoma patient using metagenomic next generation sequencing: A case report

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-06-10 DOI:10.1016/j.jiac.2025.102752

Qingming Guo , Le Wang , Bin Han , Xiaofeng Mu , Weiwei Wu , Qingqing Bi , Juan Chen

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Abstract

Whipple's disease (WD) is a rare chronic infectious illness caused by Tropheryma whipplei (T.whipplei), primarily affecting the gastrointestinal tract and joints, with rare lung involvement. Diagnosis can be challenging due to nonspecific symptoms and the difficulty in isolating the bacterium. This report describes a patient with pneumonia resulting from T.whipplei and Streptococcus pneumoniae infections during lymphoma treatment with chemotherapy and glucocorticoids. Imaging revealed pulmonary infections characterized by diffuse ground glass opacities and small nodules. Metagenomic sequencing of bronchoalveolar lavage fluid confirmed the mixed infection. The patient was treated with moxifloxacin and ceftriaxone, leading to improved inflammation within eight days. After completing chemotherapy, the patient was discharged with significant remission. This case highlights the susceptibility of immunocompromised patients to T.whipplei infection, emphasizing the need for early diagnosis and treatment.

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使用下一代宏基因组测序诊断免疫功能低下淋巴瘤患者的乳头状瘤肺炎：1例报告

惠普尔病（Whipple's disease， WD）是一种罕见的由惠氏Tropheryma whiipplei （t.w ipplei）引起的慢性感染性疾病，主要影响胃肠道和关节，很少累及肺部。由于非特异性症状和分离细菌的困难，诊断可能具有挑战性。本报告描述了一名患者在淋巴瘤化疗和糖皮质激素治疗期间，因惠氏绦虫和肺炎链球菌感染而引起的肺炎。影像学显示肺部感染，表现为弥漫性磨玻璃混浊和小结节。支气管肺泡灌洗液宏基因组测序证实混合性感染。患者给予莫西沙星和头孢曲松治疗，8天内炎症得到改善。化疗完成后，患者出院，病情明显缓解。本病例突出了免疫功能低下患者对惠氏弓形虫感染的易感性，强调了早期诊断和治疗的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.