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Case Reports
. 2024 Feb 7;27(4):133.
doi: 10.3892/etm.2024.12421. eCollection 2024 Apr.

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

Yue Deng  1 , Hongmei Zhang  1 , Junyu Lu  1 , Zhiyu Zhou  2 , Ting Zhang  2 , Xuerong Cui  3
Affiliations
Case Reports

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

Yue Deng et al. Exp Ther Med. .

Abstract

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.

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

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Comparison of chest CT in patient 1. (A-C) Chest CT in July 2023. (D-F) Chest CT 2 weeks later. (G-I) Chest CT in August 2023. The lesions were more clearly absorbed in August compared with at the first CT scan in July.
Figure 2
Figure 2
Comparison of chest CT in patient 2. (A-C) Chest CT in March 2023. (D-F) Chest CT in April 2023. (G-I) Chest CT in August 2023. The lesions were more clearly absorbed in August compared with in March.
Figure 3
Figure 3
Comparison of chest CT in patient 3. (A-C) Chest CT in January 2022. (D-F) Chest CT 2 weeks later. (G-I) Chest CT in March 2022. The lesions were more clearly absorbed in March compared with at the first CT scan in January.
See this image and copyright information in PMC

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