Work

Tropheryma whipplei in interstitial lung disease: A case series

Year: 2025

Type: article

Abstract: Tropheryma whipplei (TW) is a bacterium associated with Whipple's disease (WD). It primarily affects the small intestine, heart and eyes, but some studies have explored its relationship with parenchymal disease. With technological advances, next-generation technology has enabled detection of TW in bronchoalveolar lavage (BALF),especially in patients with interstitial lung disease (ILD). We describe three patients with ILD that was progressive, despite aggressive treatment. Next generation sequecning of BALF revealed the presence of TW, confirmed by polymerase chain reaction (PCR). Periodic acid-Schiff (PAS)-positive macrophages were identified in duodenal biopsy specimens from one patient. All three patients were prescribed doxycycline and hydroxychloroquine, as well as pharmacotherapy for ILD. During 3–6 months follow-up, TW was not detected in BALF and ILD was stable. We report TW detection in BALF of 3 ILD patients, indicating its potential role as a disease-modifying pathogen in ILD progression. These cases underscore the impact of lung microbiome disturbances on ILD pathophysiology and highlight therapeutic implications.

Source: Respiratory Medicine Case Reports

DOI: 10.1016/j.rmcr.2025.102279