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Tropheryma whipplei infection in the lung of a patient with long COVID: a case report.

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  • Author(s): Ruan W;Ruan W; Xu J; Xu J; Yang F; Yang F; Wu X; Wu X; Ying K; Ying K
  • Source:
    BMC infectious diseases [BMC Infect Dis] 2024 Mar 06; Vol. 24 (1), pp. 292. Date of Electronic Publication: 2024 Mar 06.
  • Publication Type:
    Case Reports; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      COVID-19*/complications ; COVID-19*/diagnosis ; Actinomycetales Infections*; Male ; Humans ; Middle Aged ; Post-Acute COVID-19 Syndrome ; Tropheryma ; Dyspnea ; Lung/diagnostic imaging
    • Abstract:
      Background: Immune dysregulation in individuals with long COVID has been detected. Differential diagnosis of diffuse infiltration on chest CT in long COVID is challenging.
      Case Presentation: A 62-year-old man presented with a 10-month history of dyspnea after COVID-19 infection. Dyspnea became worse in the one month preceding presentation. The chest CT showed multifocal, subpleural, bilateral opacities due to long-COVID, and infiltration around the bronchovascular bundle in the bilateral lower lung field. The pathology for the transbronchial cryobiopsy (TBCB) first reported chronic inflammation (mainly interstitial pneumonia). The patient had positive results on tests for the antibody, RO-52+, EJ+. The presumptive diagnosis of connective tissue disease-interstitial lung disease was made. Prednisone and cyclophosphamide were given. At follow-up one month later, the chest CT showed new diffuse ground-glass infiltration. The previous TBCB specimen was re-evaluated. Foamy macrophages were found in the alveolar air space. Periodic acid-Schiff (PAS) staining was performed. Numerous intracytoplasmic organisms were detected, with morphologic features consistent with those of Tropheryma whipplei. The patient recovered after intravenous ceftriaxone and oral trimethoprim-sulfamethoxazole. The final diagnosis was lung T. whipplei infection and long COVID-19.
      Conclusion: This is the first case report of Tropheryma whipplei infection in the lung of a patient with long COVID-19. T. whipplei should be considered as a potential pathogen for diffuse lung infiltration in the post-COVID-19 era.
      (© 2024. The Author(s).)
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    • Grant Information:
      Y202351581 the Scientific Research Fund of the Zhejiang Provincial Education Department; Y202351581 the Scientific Research Fund of the Zhejiang Provincial Education Department; Y202351581 the Scientific Research Fund of the Zhejiang Provincial Education Department; Y202351581 the Scientific Research Fund of the Zhejiang Provincial Education Department; Y202351581 the Scientific Research Fund of the Zhejiang Provincial Education Department; LY17H160007 the Zhejiang Provincial Natural Science Foundation of China; LY17H160007 the Zhejiang Provincial Natural Science Foundation of China; LY17H160007 the Zhejiang Provincial Natural Science Foundation of China; LY17H160007 the Zhejiang Provincial Natural Science Foundation of China; LY17H160007 the Zhejiang Provincial Natural Science Foundation of China
    • Contributed Indexing:
      Keywords: Long COVID; Lung; Tropheryma whipplei
    • Publication Date:
      Date Created: 20240306 Date Completed: 20240308 Latest Revision: 20240309
    • Publication Date:
      20240309
    • Accession Number:
      PMC10916207
    • Accession Number:
      10.1186/s12879-024-09183-6
    • Accession Number:
      38448808