【摘要】 惠普尔养障体(TW)为革兰阳性需氧杆菌,过碘酸希夫(PAS)染色阳性,抗酸染色阴性。由其引起的惠普尔病(WD)是一种慢性多系统感染,胃肠道最常受累,肺部受累罕见。本文报道的77岁男性患者以发热、咳嗽、呼吸困难为主要表现,胸部CT示双肺弥漫性感染伴纤维化;支气管肺泡灌洗液宏基因组二代测序检出TW感染,先后给予哌拉西林-舒巴坦、美罗培南抗感染,肺炎病情仍持续恶化。鉴于TW感染所致肺炎报道甚少,本病例或可为其临床诊断与治疗提供借鉴。更多还原

【Abstract】 Tropheryma Whipplei(TW) is a Gram-positive aerobic bacillus. It is positive for periodic acid schiff(PAS) staining and negative for acid-fast staining. The Whipple’s disease(WD) caused by TW is a chronic multi-system infection, with the gastrointestinal tract being the most frequently affected areas, while lung involvement is rare. The 77-year-old male patient reported in this article presented mainly with fever, cough, and shortness of breath. Chest CT showed diffuse infection and fibrosis in both lungs; metagenomic next generation sequencing of bronchoalveolar lavage fluid detected TW infection. Antimicrobial treatment with Piperacillin-Tazobactam and Meropenem was given, but the condition of pneumonia continued to deteriorate. In view of the fact that there are few reports on pneumonia caused by TW infection, this case may provide reference for its clinical diagnosis and treatment.更多还原