Clinically Suspected Whipple Disease Presenting with Acute Kidney Injury as the Initial Manifestation and Complicated by Severe Pneumonia Requiring Veno-Venous Extracorporeal Membrane Oxygenation
Abstract
Background: Whipple disease (WD) is a chronic, multisystem infectious disorder caused by the Gram-positive bacterium Tropheryma whipplei (T. whipplei). Classical presentations most commonly include intermittent arthralgia or arthritis, often accompanied by chronic gastrointestinal symptoms such as abdominal pain and diarrhea. Owing to its broad clinical spectrum and the absence of pathognomonic features, early diagnosis remains challenging.
Case report: This report describes a patient with T. whipplei infection who presented with acute kidney injury as the initial and predominant manifestation, an uncommon presentation of WD. The clinical course rapidly progressed to severe pneumonia and severe acute respiratory distress syndrome, necessitating veno-venous extracorporeal membrane oxygenation (ECMO) support. Following intensive management, renal function showed gradual improvement, evidenced by increased urine output and a reduction in serum creatinine levels, while chest imaging demonstrated mild radiological improvement. Despite these findings, the patient subsequently died after the family declined further treatment.
Conclusion: This case offers clinically relevant insights into an atypical presentation of clinically suspected WD. Acute kidney injury (AKI), manifested initially by reduced urine output and elevated serum creatinine, constituted the primary presentation. Moreover, there is a paucity of literature from China describing the use of ECMO in the management of…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Structural and topological analysis of thiosemicarbazone-based metal complexes: computational and experimental study of bacterial biofilm inhibition and antioxidant activity
- Toward better cures for Mycobacterium abscessus lung disease
- Challenges for global antibiotic regimen planning and establishing antimicrobial resistance targets: implications for the WHO Essential Medicines List and AWaRe antibiotic book dosing
- Design, Synthesis and In vitro Antitubercular Effect of New Chalcone Derivatives Coupled with 1,2,3‐Triazoles: A Computational Docking Techniques
- Upregulation of pmrA, pmrB, pmrC, phoQ, phoP, and arnT genes contributing to resistance to colistin in superbug Klebsiella pneumoniae isolates from human clinical samples in Tehran, Iran
- Whole-genome sequencing of clinical isolates of Citrobacter Europaeus in China carrying blaOXA−48 and blaNDM−1
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.