TITLE:
A Rare Case of Pneumonia Caused by Tropheryma Whipplei
AUTHORS:
Jing Feng, Junjiang Lu, Zhaohui Liu
KEYWORDS:
Whipple’s Disease, Pneumonia, Metagenomic Next-Generation Sequencing, Rare Pathogen
JOURNAL NAME:
Open Journal of Internal Medicine,
Vol.15 No.4,
December
1,
2025
ABSTRACT: Objective: To report a rare case of pneumonia caused by Tropheryma whipplei (TW) and to explore its clinical characteristics, diagnostic approach, and therapeutic strategy, aiming to provide a reference for the recognition of atypical pulmonary infections. Methods: The clinical data, imaging findings, and laboratory results of the patient were retrospectively analyzed. Relevant literature from recent years was reviewed to summarize the diagnostic and therapeutic experience of pulmonary infection caused by T. whipplei. Results: The patient presented with fever, cough, and fatigue. Chest CT revealed multiple patchy opacities and bilateral pleural effusions. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) identified T. whipplei (9747 specific reads), confirming the diagnosis of Whipple’s disease-related pneumonia. The patient was treated with meropenem combined with doxycycline, and no recurrence was observed during a 3-month follow-up. Conclusion: Tropheryma whipplei can cause isolated pulmonary infection with nonspecific clinical manifestations. mNGS plays a pivotal role in establishing the diagnosis. Early recognition and adequate antimicrobial therapy can significantly improve prognosis.