Tropheryma whipplei Pneumonia with Myelofibrosis: A Rare Actinomycetia Case Report and Literature Review.
Liu Junbao J, Wang Xing X, Xie Peitao P, Dong Lisen L et al.
Tropheryma whipplei (T. whipplei) is an uncommon pathogen that infects multiple sites, predominantly the gastrointestinal tract. However, pulmonary involvement is uncommon, and its clinical manifestations and imaging features lack specificity, making it prone to misdiagnosis. However, with the development of metagenomic next-generation sequencing (mNGS), clinicians have a potent tool at their disposal for detecting T. whipplei infections. We report a case of an elderly woman with a history Myelofibrosis who presented with a dry cough, fever, fatigue and difficulty breathing. Routine microbiological tests were negative; mNGS of bronchoalveolar lavage fluid (BALF) suggested T. whipplei infection. Following a definitive diagnosis, the patient was treated with a regimen of meropenem in combination with trimethoprim-sulfamethoxazole (TMP-SMX) for 16 days followed by 2 weeks of TMP-SMX maintenance, after which the patient improved and was discharged uneventfully.