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Volume 30, Number 5—May 2024
Research Letter

Novel Patterns in High-Resolution Computed Tomography in Whipple Pneumonia

Hui LiComments to Author , Jiajia Wu, Xiaojun Mai, Wan Zeng, Shuping Cai, Xiuji Huang, Chunxia Zhou, Jin Li, Qin Jiang, Chunliu Lai, and Canmao XieComments to Author 
Author affiliation: The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China

Main Article

Table

Categorized data from previously published studies on high-resolution CT findings, symptoms, inflammatory indicators, and immune status in patients with Tropheryma whipplei infection*

Study (reference) Patient age, y/sex CT findings Symptoms Inflammatory indicators Patient immune status
Fenollar et al. (2)
 70/F
 Diffuse bilateral micronodular involvement, mediastinal lymphadenopathy
 Nocturnal sweats, fever, dyspnea, myalgia, arthralgia, diarrhea
 Unremarkable leukocyte and CRP levels
 Immunocompetent
Stein et al. (3)
 24/M
 Right upper lobe pneumonia and bilateral alveolar condensation
 Dyspnea, productive cough, high-grade fever
 Elevated leukocyte and CRP levels
 HIV
Zhang and Xu (4)
 26/M
 A thick-walled cavity in the left upper lung
 Breathing-related chest pain
 Unremarkable leukocyte and CRP levels
 Immunocompetent
Kelly et al. (5)
 31/M
 Several discrete nodules
 Dry cough with progressive weight loss, malaise, poor appetite
 Elevated ESR
 Immunocompetent
Li et al. (6)
 39/F
 Diffuse bilateral ground glass opacity and consolidation
 Coughing, dyspnea, low-grade fever
 Elevated neutrophil and CRP levels
 Immunocompetent
Canessa et al. (7)
 60/F
 Alveolar consolidation in the left lower lobe, pleural effusion
 Diarrhea, progressive dyspnea, dry cough, weight loss
 Unknown
 Unknown
Lin et al. (8) Mixed Nodular type: ground glass nodules or solid nodules; pneumonia type: focal or patchy mixed density shadow; other manifestations: cavity, cystic, or pleural effusion. Respiratory symptoms, weight loss, fever, rare gastrointestinal symptoms Unremarkable leukocyte and CRP levels Unknown

*CRP, C-reactive protein; CT, computed tomography; ESR, erythrocyte sedimentation rate.

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References
  1. Boumaza  A, Ben Azzouz  E, Arrindell  J, Lepidi  H, Mezouar  S, Desnues  B. Whipple’s disease and Tropheryma whipplei infections: from bench to bedside. Lancet Infect Dis. 2022;22:e280–91. DOIPubMedGoogle Scholar
  2. Fenollar  F, Ponge  T, La Scola  B, Lagier  JC, Lefebvre  M, Raoult  D. First isolation of Tropheryma whipplei from bronchoalveolar fluid and clinical implications. J Infect. 2012;65:275–8. DOIPubMedGoogle Scholar
  3. Stein  A, Doutchi  M, Fenollar  F, Raoult  D. Tropheryma whipplei pneumonia in a patient with HIV-2 infection. Am J Respir Crit Care Med. 2013;188:1036–7. DOIPubMedGoogle Scholar
  4. Zhang  WM, Xu  L. Pulmonary parenchymal involvement caused by Tropheryma whipplei. Open Med (Wars). 2021;16:843–6. DOIPubMedGoogle Scholar
  5. Kelly  CA, Egan  M, Rawlinson  J. Whipple’s disease presenting with lung involvement. Thorax. 1996;51:343–4. DOIPubMedGoogle Scholar
  6. Li  W, Zhang  Q, Xu  Y, Zhang  X, Huang  Q, Su  Z. Severe pneumonia in adults caused by Tropheryma whipplei and Candida sp. infection: a 2019 case series. BMC Pulm Med. 2021;21:29. DOIPubMedGoogle Scholar
  7. Canessa  PA, Pratticò  L, Sivori  M, Magistrelli  P, Fedeli  F, Cavazza  A, et al. Acute fibrinous and organising pneumonia in Whipple’s disease. Monaldi Arch Chest Dis. 2008;69:186–8.PubMedGoogle Scholar
  8. Lin  M, Wang  K, Qiu  L, Liang  Y, Tu  C, Chen  M, et al. Tropheryma whipplei detection by metagenomic next-generation sequencing in bronchoalveolar lavage fluid: A cross-sectional study. Front Cell Infect Microbiol. 2022;12:961297. DOIPubMedGoogle Scholar
  9. Duss  FR, Jaton  K, Vollenweider  P, Troillet  N, Greub  G. Whipple disease: a 15-year retrospective study on 36 patients with positive polymerase chain reaction for Tropheryma whipplei. Clin Microbiol Infect. 2021;27:910.e9–13. DOIPubMedGoogle Scholar
  10. Lagier  JC, Papazian  L, Fenollar  F, Edouard  S, Melenotte  C, Laroumagne  S, et al. Tropheryma whipplei DNA in bronchoalveolar lavage samples: a case control study. Clin Microbiol Infect. 2016;22:875–9. DOIPubMedGoogle Scholar

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Page updated: April 24, 2024
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