Diagnosis of Tropheryma whipplei pneumonia in an immunocompromised lymphoma patient using metagenomic next generation sequencing: A case report.

Whipple's disease (WD) is a rare chronic infectious illness caused by Tropheryma whipplei (T.whipplei), primarily affecting the gastrointestinal tract and joints, with rare lung involvement. Diagnosis can be challenging due to nonspecific symptoms and the difficulty in isolating the bacterium. This report describes a patient with pneumonia resulting from T.whipplei and Streptococcus pneumoniae infections during lymphoma treatment with chemotherapy and glucocorticoids. Imaging revealed pulmonary infections characterized by diffuse ground glass opacities and small nodules. Metagenomic sequencing of bronchoalveolar lavage fluid confirmed the mixed infection. The patient was treated with moxifloxacin and ceftriaxone, leading to improved inflammation within eight days. After completing chemotherapy, the patient was discharged with significant remission. This case highlights the susceptibility of immunocompromised patients to T.whipplei infection, emphasizing the need for early diagnosis and treatment.