Tropheryma Whipplei Infections and Associated Pathologies
Summary
Tropheryma whipplei is a Gram-positive actinobacterium responsible for a spectrum of human diseases ranging from classic Whipple’s disease to more localized and transient infections. Classic Whipple’s disease is a multisystem disorder characterised by malabsorption, weight loss, diarrhoea and arthralgia, often culminating in cardiac and neurological complications if untreated. The bacterium can also manifest in culture-negative endocarditis, pneumonia and acute gastroenteritis, with many individuals harbouring asymptomatic carriage in the oro-intestinal tract. Diagnosis typically relies on detecting periodic acid–Schiff-positive macrophages in tissue biopsies alongside polymerase chain reaction assays for bacterial DNA. Treatment regimens centre on prolonged antibiotic courses, frequently combining trimethoprim–sulfamethoxazole or doxycycline with hydroxychloroquine, but immune reconstitution inflammatory syndrome (IRIS) may complicate therapy. Epidemiological surveys reveal widespread environmental distribution and variable colonisation rates across age groups and regions, underscoring the global relevance of T. whipplei and the need for heightened clinical awareness.
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Tropheryma Whipplei Infections and Associated Pathologies publication trend
The graph below shows the total number of articles in tropheryma whipplei infections and associated pathologies across all publications each year (not limited to Nature Index journals).
Technical terms
Actinobacterium: A phylum of Gram-positive bacteria with high guanine–cytosine content, to which Tropheryma whipplei belongs.
Periodic acid–Schiff (PAS)-positive macrophages: Immune cells in tissue biopsies that stain with PAS reagent due to abundant polysaccharide-rich debris, indicative of Whipple’s disease.
Polymerase chain reaction (PCR): A molecular technique used to amplify and detect specific DNA sequences of T. whipplei in clinical specimens.
Immune reconstitution inflammatory syndrome (IRIS): A paradoxical exacerbation of inflammation following the recovery of immune function during antimicrobial therapy.
Metagenomic next-generation sequencing: A high-throughput method for identifying microbial DNA directly from clinical samples without prior culture.
References
- Current knowledge of the immune reconstitution inflammatory syndrome in Whipple disease: a review. Frontiers in Immunology (2023).
- Novel Patterns in High-Resolution Computed Tomography in Whipple Pneumonia - Volume 30, Number 5—May 2024 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2024).
- Whipple's disease: A rare disease that can be spotted by many doctors. European Journal of Internal Medicine (2023).
- Tropheryma whipplei Colonization in Adults and Children: A Prospective Study. Microorganisms (2024).
- Tropheryma whipplei Endocarditis - Volume 19, Number 11—November 2013 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2013).
- Tropheryma whipplei in Patients with Pneumonia - Volume 16, Number 2—February 2010 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2010).
- Tropheryma whipplei in Children with Gastroenteritis - Volume 16, Number 5—May 2010 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2010).
- Severe pneumonia in adults caused by Tropheryma whipplei and Candida sp. infection: a 2019 case series. BMC Pulmonary Medicine (2021).
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