[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-459942-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-459942-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","tropheryma-whipplei-an-underestimated-pathogen-associated-with-pulmonary-infections-letter-to-the-editor","Tropheryma whipplei: An Underestimated Pathogen Associated with Pulmonary Infections - Letter to the Editor","","Rod-shaped, Gram-positive Tropheryma whipplei is known for causing Whipple disease and has also been detected in acute infections and multiple human samples, including respiratory specimens where DNA signals a possible link to lung disease. A 2024–2025 analysis of 1,308 bronchoalveolar lavage samples used metagenomic next-generation sequencing and found 52 positives (3.98%). Patients averaged 52.23 years, with 78.85% over 40, and incidence showed no clear pattern. Most cases involved co-detection, yet read dominance in many patients suggests T. whipplei may frequently act as a predominant etiological agent despite being considered rare.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/tropheryma-whipplei-an-underestimated-pathogen-associated-with-pulmonary-infections-letter-to-the-editor/459942/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/tropheryma-whipplei-an-underestimated-pathogen-associated-with-pulmonary-infections-letter-to-the-editor/459942.png","ImageObject",300,407,{"name":42,"@type":43},"Dipper","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"How was Tropheryma whipplei detected in this study?","Question",{"text":62,"@type":63},"The study analyzed bronchoalveolar lavage samples using metagenomic next-generation sequencing (NGS) at Jining First People's Hospital.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What proportion of bronchoalveolar lavage samples tested positive for Tropheryma whipplei?",{"text":67,"@type":63},"Out of 1,308 samples, 52 were positive, corresponding to 3.98%.",{"name":69,"@type":60,"acceptedAnswer":70},"Why do the authors suggest Tropheryma whipplei may be a predominant cause of pulmonary infections?",{"text":71,"@type":63},"In many cases, the number of sequencing reads for T. whipplei was markedly higher than other co-detected agents, indicating it may often be the primary etiological organism.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},459942,1790757307,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":79,"read_time":110,"preview_page_count":4},1374404997633,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Letter to the Editor  \nTropheryma whipplei: An Underestimated Pathogen Associated with Pulmonary Infections?  \nJingjing Jiang1,*, Haimin Wang2,*, Haijian Zhou3,*, Hai Jiang3, Wei Liu1, Wenguo Jiang1, Mingfang Xu2 and Kun Li3  \n1Jining Center for Disease Control and Prevention, Jining, 2Jining First People’s Hospital, Jining, 3National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China  \nTropheryma whipplei is a rod-shaped, Gram-positive bacterium that belongs to the family Tropherymataceae, order Micrococcales, class Actinomycetes. It is primarily recognized as the causative agent of Whipple disease, a rare chronic condition characterized by symptoms such as diarrhea, weight loss, arthritis, spondylodiscitis, endocarditis, and lymphadenopathy1. Acute infections caused by T. whipplei have also been reported, leading to gastroenteritis and bacteremia2. Additionally, T. whipplei has been found in various human samples, including blood, urine, heart valves, myocardium, and skeletal muscle3. Its presence in human saliva and stool ranges from approximately 0. 2% to 2. 3%4, indicating that asymptomatic carriers may commonly harbor the bacterium. Since 2007, an increasing number of studies have detected the DNA of T. whipplei in bronchoalveolar lavage (BAL) and other respiratory samples from patients with pneumonia, asthma, or interstitial lung disease, suggesting a potential link between the bacterium and respiratory illnesses. A case-control study conducted in 2016 established the causative role of T. whipplei in pneumonia5. Despite this evidence, pulmonary infections caused by T. whipplei are still regarded as rare.  \nFrom January 2024 to July 2025, a total of 1,308 BAL samples from patients diagnosed or suspected of having pulmonary infections were analyzed using metagenomic next-generation sequencing (NGS) at Jining First People's Hospital in Shandong Province, China. After retrospective analysis, 52 cases (3 .98%) were tested positive for T. whipplei. The average age of the patients was 52.23 years, with 78.85% being over 40 years old (Table 1), indicating that older individuals are more susceptible to T. whipplei. Analysis of the monthly incidence rates showed no obvious patterns; however, April and May appeared to be low-incidence months for T. whipplei infection (Supplementary Figure S1) .  \nIn most cases, T. whipplei was found alongside various other pathogens, including bacteria, viruses, and fungi. It was identified as the sole pathogen in only three patients: a 58-year-old woman with community-acquired pneumonia, a 60-yearold man with a suspected lung infection, and another 60-year-old man with severe pneumonia. Among the remaining 49 patients, T. whipplei was most frequently co-detected with Herpesvirus (44 .90%, 22/49), Aspergillus spp. (32 . 65%, 16/49), Mycoplasma pneumoniae (24 .49%, 12/49), and Mycobacterium spp. (18 . 37%, 9/49) . Other co-detected agents included Streptococcus pneumoniae (10 . 20%, 5/49), Klebsiella pneumoniae (8 . 16%, 4/49), Staphylococcus aureus (8 . 16%, 4/49), Acineto bacter baumann ii (6 . 12%, 3/49), Rhizomucor spp. (6 . 12%, 3/49), and Candida spp. (6 . 12%, 3/49) (Supplementary Table S1) . Differentiating whether these mi-  \n[https://doi.org/10.4046/trd.2025.0152](https://doi.org/10.4046/trd.2025.0152)  \nISSN: 1738-3536(Print)/ 2005-6184(Online)  \nTuberc Respir Dis 2026;89:114-116  \nCopyright © 2026 The Korean Academy of Tuberculosis and Respiratory Diseases  \nAddress for correspondence Kun Li  \nNational Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206, Beijing, China Phone 86-10-58900767  \nE-mail [likun@icdc.cn](likun@icdc.cn)  \n[Received](Received Sep. 7)[ Sep. 7](Received Sep. 7), 2025  \nRevised Sep. 16, 2025  \nAccepted Oct. 27, 2025  \nPubl","cbCaidgKBowZwgkW","https://ap.wps.com/l/cbCaidgKBowZwgkW","pdf",106547,"English","# Letter to the Editor: Tropheryma whipplei: An Underestimated Pathogen Associated with Pulmonary Infections\n## Background and rationale\n## Study design and detection results (2024–2025)\n## Co-detection patterns and read dominance","[{\"question\":\"How was Tropheryma whipplei detected in this study?\",\"answer\":\"The study analyzed bronchoalveolar lavage samples using metagenomic next-generation sequencing (NGS) at Jining First People's Hospital.\"},{\"question\":\"What proportion of bronchoalveolar lavage samples tested positive for Tropheryma whipplei?\",\"answer\":\"Out of 1,308 samples, 52 were positive, corresponding to 3.98%.\"},{\"question\":\"Why do the authors suggest Tropheryma whipplei may be a predominant cause of pulmonary infections?\",\"answer\":\"In many cases, the number of sequencing reads for T. whipplei was markedly higher than other co-detected agents, indicating it may often be the primary etiological organism.\"}]","Tropheryma whipplei: An Underestimated Pathogen Associated with Pulmonary Infections - Letter to the Editor | PDF"]