惠普尔养障体呼吸系统感染的诊断挑战与治疗争议OA

Tropheryma whipplei(TW)is an opportunistic pathogen causing Whipple's disease.With the deve-lopment of molecular diagnostic technology,the detection rate of this pathogen from respiratory specimens has increased,but its definite pathogenic role in respiratory infection remains controversial.TW pulmonary infection lacks specific symptoms;cough is the most common symptom,and imaging examination typically reveals nodules,interstitial changes,or pleural effusion.The gold standard for the diagnosis of classic Whipple's disease which mainly affected the digestive system in the past is histological examination of the duodenum.However,for isolated respiratory infection,molecular detection technology based on bronchoalveolar lavage fluid(BALF)has become the main diagnostic method.The treatment strategy has shifted from empirical medication to personalized therapy based on in vitro drug sensitivity.Ceftriaxone or meropenem,which are able to penetrate the blood-brain barrier,are initially recommended for treatment,but there are differences in the follow-up maintenance strategies.This review aims to systematically elucidate the research progress in clinical diagnosis and treatment of TW respiratory system infection.