Why the study?
Tropheryma whipplei is a rare cause of infective endocarditis that poses a diagnostic challenge in culture-negative cases.
Tissue 16S rRNA gene sequencing is critical for diagnosing fastidious organisms like Tropheryma whipplei in culture-negative endocarditis.
Supports 16S rRNA sequencing in culture-negative endocarditis with arthralgia; leaves open broader diagnostic adoption pending validation.
A 66-year-old man with arthralgia and fever of unknown origin developed progressive aortic and mitral regurgitation with vegetations. Despite a staged and extensive diagnostic work-up over six months, no pathogen was identified. Ultimately, valve replacement surgery was performed, and 16S rRNA gene sequencing of the excised valve tissue confirmed the presence of T. whipplei . The patient was successfully treated with ceftriaxone and long-term trimethoprim-sulfamethoxazole. Tropheryma whipplei is a rare cause of infective endocarditis (IE) that poses a diagnostic challenge. This case highlights the critical role of molecular diagnostics in identifying fastidious organisms in patients with culture-negative endocarditis.
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Maeda et al. (2025) studied this question.
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