惠普尔养障体重症肺炎1例报告

Severe Tropheryma whipplei pneumonia: a case report

惠普尔养障体是一种革兰阳性杆菌,属于苛养菌,临床常难以确诊。惠普尔氏病是由惠普尔养障体引起的一种慢性多系统感染性疾病,常见的靶器官是胃肠道、关节,肺部罕见受累。本文报告患者临床表现为发热、咳嗽、呼吸困难,双肺CT提示弥漫性磨玻璃影,支气管镜肺泡灌洗液宏基因测序提示为惠普尔养障体、热带念珠菌混合感染,给予美罗培南、复方磺胺甲口恶唑、氟康唑治疗好转。本文就该例惠普尔养障体肺炎病例进行报告及文献复习,旨在提高临床对惠普尔养障体感染的认识,做到早诊断、早治疗。

Tropheryma whipplei(TW) is a kind of Gram-positive bacterium, which belongs to fastidious bacteria and is often difficult to be diagnosed clinically. Whipple’s disease is a chronic multi-system infectious disease caused by TW, the common target organs are gastrointestinal tract and joint, pulmonary involvement is rare. This paper reports that the clinical manifestations of the patient are fever, cough and dyspnea, CT finding shows bilateral lungs diffuse ground glass shadow. Metagenomic sequencing of bronchoalveolar lavage fluid shows mixed infection of TW and Candida tropicalis infection. The patient’s condition is improved after treated with meropenem, compound sulfamethoxazole, and fluconazole. This paper reports a case of TW pneumonia and reviews the literatures, so as to improve the clinical understanding of TW infection, achieve early diagnosis and treatment.