Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report
ABSTRACT A 54‐year‐old Chinese male was admitted to our department with fever, vomiting and dyspnea. His condition rapidly worsened within 12 h with acute respiratory distress syndrome and septic shock. We performed routine laboratory tests and metagenomic next‐generation sequencing (mNGS) of bronch...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Respirology Case Reports |
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| Online Access: | https://doi.org/10.1002/rcr2.70231 |
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| author | Yunxiang Lv Guiyun Jiang Shan Gao Huadong Wang Yong Zhang |
| author_facet | Yunxiang Lv Guiyun Jiang Shan Gao Huadong Wang Yong Zhang |
| author_sort | Yunxiang Lv |
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| description | ABSTRACT A 54‐year‐old Chinese male was admitted to our department with fever, vomiting and dyspnea. His condition rapidly worsened within 12 h with acute respiratory distress syndrome and septic shock. We performed routine laboratory tests and metagenomic next‐generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) and peripheral blood, the results of which indicated the presence of Tropheryma whipplei (TW) in BALF and no pathogens in peripheral blood. We treated him with mechanical ventilation, continuous renal replacement therapy (CRRT) for 3 days, and meropenem and trimethoprim/sulfamethoxazole (TMP/SMX), as well as other therapies for 12 days. The patient survived and showed clinical improvement, with chest computed tomography (CT) scan showing absorption of lesions. During the follow‐up period, the patient was given oral TMP/SMX and cefdinir for up to 33 days, and the chest CT scan showing almost complete absorption of lesions. Clinicians should strengthen the awareness of the presence of severe TW‐related pneumonia in a patient without immunodeficiency diseases. Rapid detection characteristics of mNGS can guide us to diagnose rare pathogenic bacteria and improve survival for those severe pneumonia patients. |
| format | Article |
| id | doaj-art-db2ef7b6f57c4015b9a113f3d8d7e3d6 |
| institution | Matheson Library |
| issn | 2051-3380 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Respirology Case Reports |
| spelling | doaj-art-db2ef7b6f57c4015b9a113f3d8d7e3d62025-06-26T15:52:48ZengWileyRespirology Case Reports2051-33802025-06-01136n/an/a10.1002/rcr2.70231Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case ReportYunxiang Lv0Guiyun Jiang1Shan Gao2Huadong Wang3Yong Zhang4Department of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Bengbu Medical University Bengbu Anhui Province People's Republic of ChinaDepartment of Clinical Laboratory The First Affiliated Hospital of Bengbu Medical University Bengbu Anhui Province People's Republic of ChinaDepartment of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Bengbu Medical University Bengbu Anhui Province People's Republic of ChinaDepartment of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Bengbu Medical University Bengbu Anhui Province People's Republic of ChinaDepartment of Pulmonary and Critical Care Medicine The First Affiliated Hospital of Bengbu Medical University Bengbu Anhui Province People's Republic of ChinaABSTRACT A 54‐year‐old Chinese male was admitted to our department with fever, vomiting and dyspnea. His condition rapidly worsened within 12 h with acute respiratory distress syndrome and septic shock. We performed routine laboratory tests and metagenomic next‐generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) and peripheral blood, the results of which indicated the presence of Tropheryma whipplei (TW) in BALF and no pathogens in peripheral blood. We treated him with mechanical ventilation, continuous renal replacement therapy (CRRT) for 3 days, and meropenem and trimethoprim/sulfamethoxazole (TMP/SMX), as well as other therapies for 12 days. The patient survived and showed clinical improvement, with chest computed tomography (CT) scan showing absorption of lesions. During the follow‐up period, the patient was given oral TMP/SMX and cefdinir for up to 33 days, and the chest CT scan showing almost complete absorption of lesions. Clinicians should strengthen the awareness of the presence of severe TW‐related pneumonia in a patient without immunodeficiency diseases. Rapid detection characteristics of mNGS can guide us to diagnose rare pathogenic bacteria and improve survival for those severe pneumonia patients.https://doi.org/10.1002/rcr2.70231metagenomic next‐generation sequencingpneumoniaTropheryma whipplei |
| spellingShingle | Yunxiang Lv Guiyun Jiang Shan Gao Huadong Wang Yong Zhang Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report Respirology Case Reports metagenomic next‐generation sequencing pneumonia Tropheryma whipplei |
| title | Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report |
| title_full | Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report |
| title_fullStr | Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report |
| title_full_unstemmed | Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report |
| title_short | Severe and Rapid Progression of Tropheryma whipplei‐Related Pneumonia With Septic Shock: A Case Report |
| title_sort | severe and rapid progression of tropheryma whipplei related pneumonia with septic shock a case report |
| topic | metagenomic next‐generation sequencing pneumonia Tropheryma whipplei |
| url | https://doi.org/10.1002/rcr2.70231 |
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