{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:49:21Z","timestamp":1787237361316,"version":"build-2736575974"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Acute eosinophilic pneumonia (AEP) is a rare but potentially severe respiratory illness.\n                    <jats:italic>Tropheryma whipplei<\/jats:italic>\n                    can also cause acute pulmonary infection, leading to atypical symptoms and computerized tomography (CT) findings. We report a case of acute eosinophilic pneumonia that was misdiagnosed as a\n                    <jats:italic>Tropheryma whipplei<\/jats:italic>\n                    infection based on targeted next-generation sequencing (tNGS) of the bronchoalveolar lavage (BAL) fluid. A 51-year-old male firefighter was admitted with a 7-day history of dry cough and 1\u202fday of fever, initially diagnosed with community-acquired pneumonia and treated empirically with antibiotics. TNGS of BAL fluid identified only\n                    <jats:italic>Tropheryma whipplei<\/jats:italic>\n                    , leading to a misdiagnosis of\n                    <jats:italic>T. whipplei<\/jats:italic>\n                    pneumonia. Despite antibiotic treatment, the patient\u2019s condition worsened, and a revised diagnosis of AEP was made based on persistent eosinophilia and pathological findings. Treatment with methylprednisolone led to rapid improvement. The detection of a high sequence count of\n                    <jats:italic>Tropheryma whipplei<\/jats:italic>\n                    as the sole bacterium in patients suspected of having acute eosinophilic pneumonia can hinder the diagnosis and treatment of the patient, highlighting the importance of differential diagnosis and the order of treatment choices.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2025.1683834","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T04:10:35Z","timestamp":1759464635000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute eosinophilic pneumonia with detection of pure Tropheryma whipplei in bronchoalveolar lavage fluid: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Yi","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1164\/rccm.201710-1967CI","article-title":"Acute eosinophilic pneumonia. Causes, diagnosis, and management","volume":"197","author":"De Giacomi","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.iac.2023.01.002","article-title":"Eosinophilic lung diseases","volume":"43","author":"Cottin","year":"2023","journal-title":"Immunol Allergy Clin N Am"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e9688","DOI":"10.1097\/MD.0000000000009688","article-title":"Drug-induced eosinophilic pneumonia: a review of 196 case reports","volume":"97","author":"Bartal","year":"2018","journal-title":"Medicine"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.rmcr.2016.08.008","article-title":"Acute eosinophilic pneumonia following recent cigarette smoking","volume":"19","author":"Thakur","year":"2016","journal-title":"Respir Med Case Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1093\/cid\/ciy668","article-title":"From whipple disease to Tropheryma whipplei infection","volume":"68","author":"Raoult","year":"2019","journal-title":"Clin Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"247","DOI":"10.2217\/fmb-2017-0178","article-title":"Acute infections caused by Tropheryma whipplei","volume":"12","author":"Lagier","year":"2017","journal-title":"Future Microbiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1186\/s13256-024-04936-y","article-title":"Pulmonary infection caused by Tropheryma whipplei: a case report and review of the literature","volume":"18","author":"Shi","year":"2024","journal-title":"J Med Case Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"4607","DOI":"10.2147\/IDR.S488740","article-title":"Short-term amoxicillin clavulanate in the treatment of pulmonary abscess caused by Tropheryma whipplei infection diagnosed by targeted next-generation sequencing: a case report and literature review","volume":"17","author":"Zhou","year":"2024","journal-title":"Infect Drug Resist"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1164\/rccm.2112056","article-title":"Idiopathic acute eosinophilic pneumonia: a study of 22 patients","volume":"166","author":"Philit","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"116374","DOI":"10.1016\/j.diagmicrobio.2024.116374","article-title":"Tropheryma whipplei detected by metagenomic next-generation sequencing in bronchoalveolar lavage fluid","volume":"109","author":"Lai","year":"2024","journal-title":"Diagn Microbiol Infect Dis"},{"key":"ref11","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":"ref12","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":"ref13","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"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"663093","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":"ref15","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":"ref16","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1183\/13993003.00405-2015","article-title":"Airway dysbiosis: Haemophilus influenzae and Tropheryma in poorly controlled asthma","volume":"47","author":"Simpson","year":"2016","journal-title":"Eur Respir J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1155\/2007\/326174","article-title":"Eosinophilic vasculitis: a rare presentation of Whipple\u2019s disease","volume":"21","author":"Al-Hamoudi","year":"2007","journal-title":"Can J Gastroenterol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1683834\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T04:10:36Z","timestamp":1759464636000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1683834\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":17,"alternative-id":["10.3389\/fmed.2025.1683834"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1683834","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]},"article-number":"1683834"}}