Abstract:

Objective To further improve the understanding of Whipple's disease(WD) as rare diseases, aiming to enhance clinicians' ability for the diagnosis of this intractable cases. Methods The clinical features and treatment process of one case respiratory WD were reported, and the literature was reviewed for discussion. Results WD can involve multiple systems, rarely involve the lungs, and the symptoms are atypical, which can be manifested as fever, dry cough, fatigue, chest pain, dyspnea, etc. Chest CT findings were mainly multiple nodules and interstitial lung disease, accompanied by mediastinal lymphadenopathy or pleural effusion. Tropheryma whippleii (TW) was detected by second-generation gene sequencing (NGS). Conclusion The course of WD is obscure, the clinical manifestation of respiratory system is atypical, and the general laboratory and imaging examinations are non-specific. The diagnosis of WD is helpful to NGS. After treatment with ceftriaxone sodium and doxycycline, the symptoms will be relieved with a good prognosis.

Key words: Whipple's disease, lung infection, fever