Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.6019
Peer-review started: July 6, 2023
First decision: July 18, 2023
Revised: July 20, 2023
Accepted: August 1, 2023
Article in press: August 1, 2023
Published online: September 6, 2023
Processing time: 56 Days and 20.5 Hours
Kidney transplantation is the standard treatment for end-stage renal disease. Particularly, rare and specific pathogenic infections which are asymptomatic are often difficult to diagnose, causing delayed and ineffective treatment and thus seriously affecting prognosis. Tropheryma whipplei (T. whipplei) is a Gram-positive actinomycete widely found in soil, sewage, and other external environments and is present in the population as an asymptomatic pathogen. There is relatively little documented research on T. whipplei in renal transplant patients, and there are no uniform criteria for treating this group of post-transplant patients. This article describes the treatment of a 42-year-old individual with post-transplant T. whipplei infection following kidney transplantation.
To analyze clinical features of Whipple’s disease and summarize its diagnosis and treatment effects after renal transplantation. Clinical data of a Whipple’s disease patient treated in the affiliated hospital of Guizhou Medical University were collected and assessed retrospectively. The treatment outcomes and clinical experience were then summarized via literature review. The patient was admitted to the hospital due to recurrent diarrhea for 1 mo, shortness of breath, and 1 wk of fever, after 3 years of renal transplantation. The symptoms of the digestive and respiratory systems were not significantly improved after adjusting immunosuppressive regimen and anti-diarrheal, empirical antibiotic treatments. Bronchoscopic alveolar fluid was collected for meta-genomic next-generation sequencing (mNGS). The deoxyribonucleic acid sequence of Tropheryma whipplei was detected, and Whipple’s disease was diagnosed. Meropenem, ceftriaxone, and other symp
Whipple’s disease is rare, with no specific symptoms, which makes diagnosis difficult. Polymerase chain reaction or mNGS should be immediately performed when the disease is suspected to confirm the diagnosis.
Core Tip: Whipple disease is rare and has no specific symptoms, which makes diagnosis difficult. When the disease is suspected, polymerase chain reaction or meta-genomic next-generation sequencing should be performed immediately to confirm the diagnosis.