Novel Patterns in High-Resolution Computed Tomography in Whipple Pneumonia

Area of Science:

• Pulmonary Medicine
• Infectious Diseases
• Genomics

Background:

• Whipple pneumonia is a rare bacterial infection caused by Tropheryma whipplei.
• Accurate diagnosis can be challenging due to non-specific symptoms and varied presentations.
• Advancements in metagenomic next-generation sequencing (mNGS) are improving diagnostic capabilities.

Observation:

• This report details three cases of Whipple pneumonia diagnosed in China.
• The patients presented with a unique pattern of movable pulmonary infiltrates.
• Upper lung micronodules were also a notable feature in these cases.

Findings:

• Metagenomic next-generation sequencing facilitated the correct diagnosis of Whipple pneumonia in all three cases.
• The observed radiological pattern, characterized by movable infiltrates and micronodules, represents a novel presentation.
• All patients demonstrated complete resolution of lung infiltrates following appropriate antimicrobial therapy.

Implications:

• The findings highlight the utility of mNGS in diagnosing challenging infectious diseases like Whipple pneumonia.
• Recognizing this novel radiological pattern may aid clinicians in earlier diagnosis and management.
• This case series contributes to the understanding of the diverse clinical and radiological spectrum of Whipple pneumonia.