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Tropheryma whipplei-induced plastic bronchitis in children: a case report

Xuefeng Jin1, Caiyun Zhang2, Chao Chen2

  • 1Department of Gastroenterology, Hangzhou Children's Hospital, Hangzhou, China.

Frontiers in Pediatrics
|June 23, 2023
PubMed

Insights

A child with severe pneumonia and plastic bronchitis was diagnosed with Tropheryma whipplei infection using metagenomic Next-Generation Sequencing. Early NGS is recommended for unexplained plastic bronchitis cases.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pulmonology

Background:

  • Plastic bronchitis is a rare condition characterized by the formation of bronchial casts.
  • Severe pneumonia in children can have various underlying causes, necessitating thorough investigation.

Observation:

  • A 7-year-old child presented with severe pneumonia, pulmonary consolidation on CT, and plastic bronchitis confirmed via bronchoscopy.
  • Metagenomic Next-Generation Sequencing (NGS) of pulmonary lavage fluid identified Tropheryma whipplei (T whipplei) as the causative agent.

Findings:

  • Successful treatment involved bronchial lavage, azithromycin, and piperacillin-tazobactam, leading to patient discharge within eight days.
  • No recurrence was observed during the follow-up period, indicating effective treatment.

Implications:

  • This case highlights Tropheryma whipplei as a potential cause of severe pneumonia and plastic bronchitis in children.
  • Early implementation of NGS for rare pathogens is crucial for diagnosing unexplained plastic bronchitis and guiding appropriate treatment.

Keywords:
childrenneat-generation sequencingpiperacillin-tazobactamplastic bronchitistropheryma whipplei

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