Tropheryma whippleiin Patients with Pneumonia

Sabri Bousbia,Laurent Chiche,Florence Fenollar,Claude Martin,Didier Raoult,Wenjun Li,Bernard La Scola,Laurent Papazian,Jean-Pierre Auffray

doi:10.3201/eid1602.090610

Abstract

Tropheryma whipplei is the etiologic pathogenic agent of Whipple disease (WD), characterized by various clinical signs, such as diarrhea, weight loss, lymphadenopathy, and polyarthritis. PCR-based methods for diagnosis of WD have been developed. T. whipplei has been identified in saliva and stool samples from patients with WD and from healthy persons. T. whipplei DNA has also been found in bronchoalveolar lavage (BAL) samples of a child with pneumonia. We detected DNA of T. whipplei in 6 (3%) of 210 BAL samples collected in intensive care units by using 16S rDNA and specific quantitative PCR. We identified 4 novel genotypes of T. whipplei. In 1 case, T. whipplei was the only bacterium; in 4 others, it was associated with buccal flora. We suggest that T. whipplei should be investigated as an etiologic agent of pneumonia.

Highlights

Tropheryma whipplei is the etiologic pathogenic agent of Whipple disease (WD), characterized by various clinical signs, such as diarrhea, weight loss, lymphadenopathy, and polyarthritis
Tropheryma whipplei is a bacterium widely known to be associated with Whipple disease (WD), which is characterized by various clinical signs such as diarrhea, weight loss, lymphadenopathy, and polyarthritis [1]
We show that T. whipplei could be a potential infectious agent for patients admitted to intensive care units (ICUs) and that it can be found in the bronchoalveolar lavage (BAL) samples of patients in ICUs

Summary

Introduction

Tropheryma whipplei is the etiologic pathogenic agent of Whipple disease (WD), characterized by various clinical signs, such as diarrhea, weight loss, lymphadenopathy, and polyarthritis. Tropheryma whipplei is a bacterium widely known to be associated with Whipple disease (WD), which is characterized by various clinical signs such as diarrhea, weight loss, lymphadenopathy, and polyarthritis [1]. Completion of the sequencing of these 2 genomes has enabled the design of highly specific and sensitive primer pairs that target repeated DNA sequences unique to the T. whipplei genome [15] These major advances have enabled the identification of T. whipplei DNA in various specimens such as saliva and stools from patients with WD, as well as from asymptomatic carriers, which suggests that the localization of the bacterium is not restricted to the digestive tract and that other organs might be affected [2,16,17,18]. We show that T. whipplei could be a potential infectious agent for patients admitted to intensive care units (ICUs) and that it can be found in the BAL samples of patients in ICUs

Methods

Results

Conclusion