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Reports of\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>T. whipplei<\/jats:italic>\n                    <\/jats:styled-content>\n                    \u2010associated pneumonia progressing to respiratory failure with concurrent acute cardiac failure remain extremely rare. A 38\u2010year\u2010old man with poorly controlled diabetes presented to the emergency department with acute chest tightness, dyspnea, and impaired consciousness. Laboratory findings indicated type II respiratory failure and elevated inflammatory markers. Imaging revealed scattered patchy hazy opacities and increased density bilaterally, prompting emergent intubation and transfer to the intensive care unit. Despite empirical antibiotics for severe pneumonia, he developed acute cardiac failure on day 3, manifesting as bloody sputum and diffuse moist rales with rhonchi on auscultation, alongside an LVEF of 49% and a markedly elevated serum BNP level of 3100\u2009pg\/mL. Metagenomic next\u2010generation sequencing (mNGS) of bronchoalveolar lavage fluid detected abundant\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>T. whipplei<\/jats:italic>\n                    <\/jats:styled-content>\n                    sequences. He was administered targeted therapy with meropenem, supported by mechanical ventilation, diuresis, and glycemic control. Cardiopulmonary function improved, and he was discharged on oral doxycycline plus hydroxychloroquine. Follow\u2010up endoscopy and biopsy showed no gastrointestinal involvement (Periodic Acid\u2010Schiff negative), restored cardiac function (LVEF 58.6%), and no recurrence. This case underscores\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>T. whipplei<\/jats:italic>\n                    <\/jats:styled-content>\n                    as a potential cause of isolated pneumonia with cardiopulmonary failure in functionally immunocompromised hosts and highlights the critical role of mNGS in guiding timely targeted therapy to improve outcomes.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.72448","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T02:35:44Z","timestamp":1775270144000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rare but Critical: Severe\n                    <scp>\n                      <i>Tropheryma Whipplei<\/i>\n                    <\/scp>\n                    Pneumonia\u2010Induced Cardiopulmonary Failure in a Young Immunocompromised Adult\u2014A Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2036-7531","authenticated-orcid":false,"given":"Guisong","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zimeng","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine II Nanchang Hongdu Hospital of Traditional Chinese Medicine  Nanchang Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.729595"},{"key":"e_1_2_12_3_1","first-page":"382","article-title":"A Hitherto Undescribed Disease Characterized Anatomically by Deposits of Fat and Fatty Acids in the Intestinal and Mesenteric Lymphatic Tissues","volume":"18","author":"Whipple G. 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