Use of metagenomic next‑generation sequencing to diagnose <i>Tropheryma whipplei</i> infection‑related pneumonia: A case report

Whipple's disease is caused by <i>Tropheryma whipplei</i> (<i>T. whipplei</i>), an uncommon pathogen that is often related to gastrointestinal symptoms. Extraintestinal involvement, particularly pulmonary manifestations, is rare and poses notable diagnostic challenges. An objective technique for identifying undiscovered infections is the application of metagenomic next-generation sequencing (mNGS). The present case report described a 55-year-old female presenting with community-acquired pneumonia (CAP), who received empirical treatment with moxifloxacin, ultimately diagnosed through mNGS performed on bronchoalveolar lavage fluid. The results indicated that the patient was infected with <i>T. whipplei</i> and that the patient exhibited notable clinical improvement within 2 weeks following intravenous moxifloxacin during hospitalization and continuation of oral moxifloxacin following discharge. The present case report highlighted the utility of mNGS in diagnosing atypical infections and identified <i>T. whipplei</i> as a potential etiological agent of CAP in immunocompetent hosts.