OBJECTIVE To explore the clinical characteristics of Tropheryma whipplei (TW) infection and observe the application of pathogenic metagenomic next-generation sequencing (mNGS) in diagnosis of TW infection.

METHODS The clinical data were collected from 1 patient who was diagnosed by mNGS in the Affiliated Hospital of Jining Medical University on Apr. 9, 2022. The data including the results of laboratory tests and treatment outcomes were summarized, and a literature review was conducted.

RESULTS A 50-year-old woman presented to the hospital with chest tightness and chest pain lasting for 3 days, accompanied by dyspnea, palpitations, and expectoration. The chest plain CT scan and magnetic resonance imaging (MRI) scan suggested a high probability of pulmonary infection. Normal flora were isolated by culture of bronchoalveolar lavage fluid (BALF); TW and human β herpes virus type 7 were detected in BALF by mNGS, with the sequence numbers 327 000 and 9, respectively. The pulmonary symptoms of the patient were improved after joint treatment of the infection with etimicin, levofloxacin and minocycline. The patient repeatedly sought for medical treatment due to the pain of shoulder joint and limitation of motion.

CONCLUSIONS TW is one of major pathogens leading to the infections of systemic multiple systems, and it is necessary to attach great importance to the diagnosis and treatment. The traditional laboratory test method can not achieve ideal diagnosis effect and is more likely to make a missed diagnosis. mNGS is more accurate and more efficient than the traditional detection method in diagnosis of TW-induced diseases. Early use of mNGS can make a rapid identification of pathogens and facilitate the reasonable clinical use of antibiotics. It is of great significance for control of the disease progression, improvement of prognosis and prevention of recurrence.