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Clinical features of Tropheryma Whipplei in pediatric pneumonia: an mNGS and tNGS-based case-control study

Yijia Pan1, Na Du2, Yong Liu1

  • 1Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, Jilin, China.

Frontiers in Cellular and Infection Microbiology
|April 2, 2026
PubMed
Abstract

Insights

Tropheryma whipplei (TW) in pediatric pneumonia is linked to milder symptoms and colonization rather than primary infection. Specific TW treatment may not be immediately necessary for these cases.

Area of Science:

  • Microbiology
  • Pediatric Pulmonology
  • Infectious Diseases

Background:

  • Tropheryma whipplei (TW), the causative agent of Whipple disease, is increasingly implicated in respiratory infections.
  • Understanding the role of TW in pediatric pneumonia is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To analyze the clinical and pathogenetic characteristics of TW in pediatric pneumonia patients.
  • To differentiate TW's role as a pathogen versus a colonizer in pediatric respiratory infections.

Main Methods:

  • Utilized metagenomic and targeted next-generation sequencing (mNGS/tNGS) on 3,759 pediatric bronchoalveolar lavage fluid (BALF) samples.
  • Conducted a case-control study comparing 103 TW-positive pediatric pneumonia patients with 206 TW-negative controls.

Main Results:

  • TW-positive patients were younger, had lower BMIs, shorter hospital stays, and milder inflammation compared to controls.
  • Severe TW-positive cases exhibited localized right-lung lesions, less pleural effusion, and more bronchial involvement.
  • Frequent co-detection of Tropheryma whipplei with Mycoplasma pneumoniae, Moraxella catarrhalis, human bocavirus type 1, and rhinovirus A.

Conclusions:

  • Tropheryma whipplei (TW)-positive pediatric pneumonia often presents with milder symptoms, suggesting a colonizing role.
  • Antimicrobial treatment targeting TW may not be immediately indicated upon detection.
  • Findings support individualized treatment strategies for pediatric pneumonia based on TW status.
Keywords:
Tropheryma whippleibronchoalveolar lavage fluidmetagenomic next-generation sequencingpediatric pneumoniatargeted next-generation sequencing

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