Whipple's disease of the respiratory system: A case report

作者全名："Deng, Yue; Zhang, Hongmei; Lu, Junyu; Zhou, Zhiyu; Zhang, Ting; Cui, Xuerong"

作者地址："[Deng, Yue; Zhang, Hongmei; Lu, Junyu] Fifth Peoples Hosp Chongqing, Dept Resp & Crit Care Med, Chongqing 400062, Peoples R China; [Zhou, Zhiyu; Zhang, Ting] Chongqing Med Univ, Dept Resp & Crit Care Med, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Cui, Xuerong] Peoples Hosp Shizhu Tujia Autonomous Cty, Dept Resp Med, Chongqing 409199, Peoples R China"

通信作者："Cui, XR (通讯作者)，Peoples Hosp Shizhu Tujia Autonomous Cty, Dept Resp Med, Chongqing 409199, Peoples R China."

来源：EXPERIMENTAL AND THERAPEUTIC MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001173514000001

JCR分区：Q3

影响因子：2.4

年份：2024

卷号：27

期号：4

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结束页：　

文献类型：Article

关键词：Whipple's disease; Tropheryma whipplei; metagenomic second-generation sequencing; respiratory system; case report

摘要："Whipple's disease (WD) is a multiple-system chronic disease caused by Tropheryma whipplei (T. whipplei) infection. The present study describes 3 cases of WD with clinical manifestations of cough, chest pain, headache, dyspnea, sputum, joint pain, abdominal pain, diarrhea and weight loss. Chest computed tomography (CT) showed signs of plaques, nodules and pleural thickening; and bronchoscopic alveolar lavage fluid metagenomic-sequencing indicated that it was T. whipplei. One patient was treated with meropenem as the starting regimen and two patients were treated with ceftriaxone as the starting regimen. Furthermore, two patients were provided with a maintenance regimen of cotrimoxazole and one was given a maintenance regimen of minocycline, which was combined with meropenem and ceftriaxone in order to improve their cough, chest pain, headache and dyspnea symptoms. To the best of our knowledge, there are few reports on WD of the respiratory system caused by T. whipplei, and differential diagnosis is the key to clinical diagnosis. When WD of the respiratory system is difficult to diagnose, metagenomic second-generation sequencing (mNGS) may be a better choice, which can achieve early diagnosis and early treatment. However, its clinical value is still limited; therefore, more research needs to be conducted in the future."

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