{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:12:51Z","timestamp":1793373171012,"version":"4.5.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>\n                    <jats:italic>Tropheryma whipplei<\/jats:italic>\n                    is the bacterium associated with Whipple\u2019s disease (WD), a chronic systemic infectious disease primarily involving the gastrointestinal tract.\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    can also be detected in different body site of healthy individuals, including saliva and feces. Traditionally,\n                    <jats:italic>Tropheryma whipplei<\/jats:italic>\n                    has a higher prevalence in bronchoalveolar lavage fluid (BALF) of immunocompromised individuals. Few studies have explored the significance of the detection of\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    in BALF. Herein, we retrospectively reviewed 1725 BALF samples which detected for metagenomic next-generation sequencing (mNGS) from March 2019 to April 2022 in Zhuhai, China. Seventy BALs (70\/1725, 4.0%) from 70 patients were positive for\n                    <jats:italic>T. whipplei.<\/jats:italic>\n                    Forty-four patients were male with an average age of 50 years. The main symptoms included cough (23\/70), expectoration (13\/70), weight loss (9\/70), and\/or dyspnea (8\/70), but gastrointestinal symptoms were rare. Chronic liver diseases were the most common comorbidity (n=15, 21.4%), followed by diabetes mellitus (n=13, 18.6%). Only nine patients (12.9%) were immunocompromised. Twenty-four patients (34.3%) were finally diagnosed with reactivation tuberculosis and 15 patients (21.4%) were diagnosed with lung tumors, including 13 primary lung adenocarcinoma and two lung metastases. Fifteen patients (21.4%) had pneumonia. Among the 20 samples,\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    was the sole agent, and Mycobacterium tuberculosis complex was the most common detected other pathogens. Among the non-tuberculosis patients, 31 (31\/46, 67.4%) had ground glass nodules or solid nodules on chest CT. Our study indicates that\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    should be considered as a potential contributing factor in some lung diseases. For non-immunocompromised patients, the detection of\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    also needs attention. The mNGS technology improves the detection and attention of rare pathogens. In the future, the infection, colonization, and prognosis of\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    in lung still need to be studied.\n                  <\/jats:p>","DOI":"10.3389\/fcimb.2022.961297","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T01:04:17Z","timestamp":1660698257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":40,"title":["Tropheryma whipplei detection by metagenomic next-generation sequencing in bronchoalveolar lavage fluid: A cross-sectional study"],"prefix":"10.3389","volume":"12","author":[{"given":"Minmin","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kongqiu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidi","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjian","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changli","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meizhu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenguo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiying","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiyan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qijiu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"258","DOI":"10.3201\/eid1602.090610","article-title":"Tropheryma whipplei in patients with pneumonia","volume":"16","author":"Bousbia","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1086\/491745","article-title":"Whipple Disease: intestinal infiltrating cells exhibit a transcriptional pattern of M2\/alternatively activated macrophages","volume":"192","author":"Desnues B, Lepidi","year":"2005","journal-title":"J. Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1128\/CMR.00033-16","article-title":"Clinical manifestations, treatment, and diagnosis of tropheryma whipplei infections","volume":"30","author":"Dolmans","year":"2017","journal-title":"Clin. Microbiol. Rev."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1007\/s10620-018-5393-9","article-title":"Epidemiology of whipple's disease in the USA between 2012 and 2017: A population-based national study","volume":"64","author":"Elchert","year":"2019","journal-title":"Dig Dis. Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.jinf.2011.11.026","article-title":"First isolation of tropheryma whipplei from bronchoalveolar fluid and clinical implications","volume":"65","author":"Fenollar","year":"2012","journal-title":"J. Infect."},{"key":"B6","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1016\/j.eimc.2015.09.006","article-title":"High prevalence of asymptomatic carriers of tropheryma whipplei in different populations from the north of Spain","volume":"34","author":"Garcia-Alvarez","year":"2016","journal-title":"Enferm Infecc Microbiol. Clin."},{"key":"B7","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":"GH","year":"1907","journal-title":"Bull. Johns Hopkins Hosp"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.760696","article-title":"Tropheryma whipplei detection by nanopore sequencing in patients with interstitial lung disease","volume":"12","author":"Guo","year":"2021","journal-title":"Front. Microbiol."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003538","article-title":"High prevalence of tropheryma whipplei in lao kindergarten children","volume":"9","author":"Keita","year":"2015","journal-title":"PLoS Negl. Trop. Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"247","DOI":"10.2217\/fmb-2017-0178","article-title":"Acute infections caused by tropheryma whipplei","volume":"2017","author":"Lagier","year":"2017","journal-title":"Future Microbiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.cmi.2016.07.010","article-title":"Tropheryma whipplei DNA in bronchoalveolar lavage samples: A case control study","volume":"22","author":"Lagier","year":"2016","journal-title":"Clin. Microbiol. Infect."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1093\/bioinformatics\/btp324","article-title":"Fast and accurate short read alignment with burrows-wheeler transform","volume":"25","author":"Li","year":"2009","journal-title":"Bioinf. (Oxford England)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12890-020-01384-4","article-title":"Severe pneumonia in adults caused by tropheryma whipplei and candida sp. infection: A 2019 case series","volume":"21","author":"Li","year":"2021","journal-title":"BMC Pulm Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1164\/rccm.201211-2145OC","article-title":"Widespread colonization of the lung by tropheryma whipplei in HIV infection","volume":"187","author":"Lozupone","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/s0140-6736(03)12274-x","article-title":"Whipple's disease","volume":"361","author":"Marth","year":"2003","journal-title":"Lancet (London England)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1053\/j.gastro.2009.07.066","article-title":"Impaired immune functions of monocytes and macrophages in whipple's disease","volume":"138","author":"Moos","year":"2010","journal-title":"Gastroenterology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1056\/nejm199207303270501","article-title":"Identification of the uncultured bacillus of whipple's disease","volume":"327","author":"Relman","year":"1992","journal-title":"New Engl. J. Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"847","DOI":"10.2217\/fmb-2019-0315","article-title":"Long-term morbidity and mortality in whipple's disease a single-center experience over 20 years","author":"Schiepatti","year":"2020","journal-title":"Future Microbiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"4061","DOI":"10.4049\/jimmunol.1101349","article-title":"Regulatory T cells in patients with whipple's disease","volume":"187","author":"Schinnerling","year":"2011","journal-title":"J. Immunol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1086\/514089","article-title":"Deactivation of macrophages with interleukin-4 is the key to the isolation of tropheryma whippelii","volume":"176","author":"Schoedon","year":"1997","journal-title":"J. Infect. Diseases"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2033","DOI":"10.1128\/AEM.02335-06","article-title":"Tropheryma whipplei in the environment: survey of sewage plant influxes and sewage plant workers","volume":"73","author":"Schoniger-Hekele","year":"2007","journal-title":"Appl. Environ. Microbiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.1378\/chest.11-1812","article-title":"Whipple Disease revealed by lung involvement: A case report and literature review","volume":"141","author":"Urbanski","year":"2012","journal-title":"Chest"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.663093","article-title":"Case report: Tropheryma whipplei hide in an AIDS patient with pneumocystis pneumonia","volume":"9","author":"Yan","year":"2021","journal-title":"Front. Public Health"},{"key":"B24","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1515\/med-2021-0297","article-title":"Pulmonary parenchymal involvement caused by tropheryma whipplei","volume":"16","author":"Zhang","year":"2021","journal-title":"Open Med. (Wars)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1186\/s13256-021-02899-y","article-title":"Pulmonary coinfection of mycobacterium tuberculosis and tropheryma whipplei: a case report","volume":"15","author":"Zhu","year":"2021","journal-title":"J. Med. Case Rep."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.961297\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T01:04:20Z","timestamp":1660698260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.961297\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,17]]},"references-count":25,"alternative-id":["10.3389\/fcimb.2022.961297"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2022.961297","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,17]]},"article-number":"961297"}}