ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical and Diagnostic Microbiology and Immunology
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1652182
This article is part of the Research TopicOmics Sciences in Microbiology and Infectious DiseasesView all 4 articles
Analysis of Clinical and Imaging Features and Prognosis of Patients Positive for Tropheryma whipplei Detected by Nanopore Sequencing of Bronchoalveolar Lavage Fluid
Provisionally accepted
Chang Song1
ChunYan Zhao1
Mei Yu1Chang-Yue Jiang1Hang-Biao Qiang1Ren- Hao Liu2Xiao-Mei Yang2Zhou-Hua Xie1*
Zhu Qingdong1*- 1The Fourth People's Hospital of Nanning, Nanning, China
- 2Guangxi Medical University, Nanning, China
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Background: To probe into the application value of nanopore sequencing in patients suffering from positive Tropheryma whipplei (TW), analyze their clinical features, imaging manifestations, and treatment prognosis, and provide new evidence for the diagnosis and treatment of Whipple's disease. Methods: This study retrospectively analyzed 2,137 samples subjected to nanopore sequencing at the Fourth People's Hospital of Nanning. Among them, 14 bronchoalveolar lavage fluid (BALF) samples were positive for TW. Patients were divided into a high-sequence group (100) and a low-sequence group (≤100) in accordance with the TW sequence counts. The clinical features, laboratory indicators, imaging manifestations, and treatment prognosis of these two groups were compared and analyzed in an all-round manner. Results: The levels of C-reactive protein (CRP) and lactate dehydrogenase (LDH) in the high-sequence group were strikingly higher than those in the low-sequence group (P < 0.05). Radiologically, TW pneumonia mostly presented as patchy shadows, ground-glass opacities, and bronchiectasis, which highly overlapped with the imaging features of tuberculosis or interstitial pneumonia. With respect to treatment, 85.7% of the 14 patients exhibited symptomatic improvement subsequent to antibiotic treatment. Fluoroquinolones and combination therapy regimens demonstrated satisfactory efficacy, but patients suffering from severe conditions or advanced age may require an extended treatment course. Conclusion: The imaging manifestations of TW pneumonia are not only non-specific, but also have been frequently mistaken with other pulmonary diseases. Notwithstanding the fact that fluoroquinolones and combination therapy regimens hold clinical relevance in the management of Whipple's disease, tailored adjustments to treatment plans are crucial based on individual patient circumstances.
Keywords: Bronchoalveolar Lavage Fluid, nanopore sequencing, Tropheryma whipplei, Clinical features, prognosis
Received: 23 Jun 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Song, Zhao, Yu, Jiang, Qiang, Liu, Yang, Xie and Qingdong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhou-Hua Xie, The Fourth People's Hospital of Nanning, Nanning, China
Zhu Qingdong, The Fourth People's Hospital of Nanning, Nanning, China
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