Pneumonia is the main manifestation combined with skin infection with Whipple's disease: report of two cases and literature review

Weiying Chen; Xuechun Li; Chuanfeng Zhang; Gen Li; Junjie Ke; Xiangkun Qu; Decai Zhu

doi:10.47297/wspbdsWSP2752-630502.20250501

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Pneumonia is the main manifestation combined with skin infection with Whipple's disease: report of two cases and literature review

Volume 5, Issue 1

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Pneumonia is the main manifestation combined with skin infection with Whipple's disease: report of two cases and literature review
Pneumonia is the main manifestation combined with skin infection with Whipple's disease: report of two cases and literature review
1.Graduate School of Bengbu Medical University, Bengbu, 233000, China
2.Department of Emergency Medicine, Bozhou People's Hospital emergency Internal Medicine, Bengbu Medical University Practice Teaching Base, Bozhou 236800, China
Vol. 5, Issue 1, Pages: 9-13(2025)
Published：19 March 2025
DOI：10.47297/wspbdsWSP2752-630502.20250501
Accepted：

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Chen Weiying,Li Xuechun,Zhang Chuanfeng,et al.Pneumonia is the main manifestation combined with skin infection with Whipple's disease: report of two cases and literature review[J].Biomedical Data Science,2025,05(01):9-13.
DOI：

Chen Weiying,Li Xuechun,Zhang Chuanfeng,et al.Pneumonia is the main manifestation combined with skin infection with Whipple's disease: report of two cases and literature review[J].Biomedical Data Science,2025,05(01):9-13. DOI： 10.47297/wspbdsWSP2752-630502.20250501.

摘要

Abstract

To explore the clinical characteristics and treatment strategies of pulmonary and cutaneous infections caused by Tropheryma whipplei. We report a case of T. whipplei infection presenting primarily as pneumonia and skin infection. Using the keywords "Whipple's disease" and "lung

" we searched the Wanfang and CNKI databases

retrieving 12 Chinese articles. Additionally

we searched PubMed and Google Scholar with the keywords "Whipple's disease" and "lungs

" reviewing 5 foreign articles. A patient with persistent symptoms of cough

sputum

and wheezing despite initial antibiotic treatment was diagnosed with T. whipplei infection through metagenomic next-generation sequencing (mNGS). After adjusting the antibiotic regimen

the patient's symptoms significantly improved. Combining this case with 19 previously reported cases

a total of 20 cases were analyzed

including 3 females and 17 males. Among them

7 patients had compromised immune systems

6 had chronic underlying diseases

3 were on long-term immunosuppressive therapy

2 had skin involvement

and 1 was on targeted therapy. Commonly used treatments included sulfamethoxazole

ceftriaxone

piperacillin-tazobactam

doxycycline

and imipenem. Following targeted antibiotic therapy

19 patients recovered

and 1 died. T. whipplei is an opportunistic pathogen

and the clinical manifestations and imaging findings of Whipple's disease are nonspecific. When initial antibiotic therapy fails

mNGS should be promptly utilized to identify the pathogen. Targeted treatment for T. whipplei generally leads to a favorable prognosis in most patients.

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references

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