Detection of <i>Tropheryma whipplei</i> Genome From the Aqueous Humor by Metagenomic Sequencing
Authors: John A. Gonzales, Thuy Doan, Annemieke VanZante, Jay M. Stewart, Amol Sura, Amit Reddy, Nailyn Rasool
Journal: Annals of Internal Medicine (2021)

LettersSeptember 2021Detection of Tropheryma whipplei Genome From the Aqueous Humor by Metagenomic SequencingJohn A. Gonzales, MD, Thuy Doan, MD, PhD, Annemieke VanZante, MD, PhD, Jay M. Stewart, MD, Amol Sura, MD, Amit Reddy, MD, and Nailyn Rasool, MDJohn A. Gonzales, MDFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, CaliforniaSearch for more papers by this author, Thuy Doan, MD, PhDFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, CaliforniaSearch for more papers by this author, Annemieke VanZante, MD, PhDUniversity of California, San Francisco School of Medicine, San Francisco, CaliforniaSearch for more papers by this author, Jay M. Stewart, MDUniversity of California San Francisco, San Francisco, CaliforniaSearch for more papers by this author, Amol Sura, MDFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, CaliforniaSearch for more papers by this author, Amit Reddy, MDFrancis I. Proctor Foundation, University of California San Francisco, San Francisco, CaliforniaSearch for more papers by this author, and Nailyn Rasool, MDUniversity of California San Francisco, San Francisco, CaliforniaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-1470 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Whipple disease rarely presents with isolated ocular symptoms and signs and is difficult to diagnose when it does.Objective: To show that Whipple disease presenting as intraocular inflammation (uveitis) can be diagnosed with metagenomic sequencing.Case Report: A 45-year-old Hispanic man was referred for visual floaters and progressive vision loss in both eyes. Although he had an unremarkable medical history, his ocular history was notable for glaucoma and cataracts in both eyes, which required surgery. He developed uveitis in both eyes 1 year ago. Six months later, he developed headaches and memory loss. His family and psychosocial history were ...References1. Doan T, Sahoo MK, Ruder K, et al. Comprehensive pathogen detection for ocular infections. J Clin Virol. 2021;136:104759. [PMID: 33609933] doi:10.1016/j.jcv.2021.104759 CrossrefMedlineGoogle Scholar2. Fenollar F, Puéchal X, Raoult D. Whipple's disease. N Engl J Med. 2007;356:55-66. [PMID: 17202456] CrossrefMedlineGoogle Scholar3. Chan RY, Yannuzzi LA, Foster CS. Ocular Whipple's disease: earlier definitive diagnosis. Ophthalmology. 2001;108:2225-31. [PMID: 11733263] CrossrefMedlineGoogle Scholar4. Testi I, Tognon MS, Gupta V. Ocular Whipple disease: report of three cases [Letter]. Ocul Immunol Inflamm. 2019;27:1117-1120. [PMID: 30192690] doi:10.1080/09273948.2018.1518461 CrossrefMedlineGoogle Scholar5. Touitou V, Fenollar F, Cassoux N, et al. Ocular Whipple's disease: therapeutic strategy and long-term follow-up. Ophthalmology. 2012;119:1465-9. [PMID: 22420960] doi:10.1016/j.ophtha.2012.01.024 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CaliforniaUniversity of California, San Francisco School of Medicine, San Francisco, CaliforniaUniversity of California San Francisco, San Francisco, CaliforniaDisclaimer: The authors are solely responsible for the content of this work, and the views expressed do not necessarily represent the official views of the National Institutes of Health.Financial Support: By the Research to Prevent Blindness Career Development Award (Dr. Doan), the National Eye Institute of the National Institutes of Health under award K08EY026986 (Dr. Doan), the Huang Pacific Foundation (Drs. Gonzales and Doan), and in part by That Man May See and an unrestricted grant from the Research to Prevent Blindness.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-1470.Corresponding Author: Thuy Doan, MD, PhD, Francis I. Proctor Foundation, University of California San Francisco, 490 Illinois Street, Second Floor, San Francisco, CA 94158; e-mail, Thuy.[email protected]edu.This article was published at Annals.org on 15 June 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLaboratory Investigations in Infectious UveitisA 21st Century Appraisal of Whipple’s Disease and Tropheryma whipplei September 2021Volume 174, Issue 9Page: 1329-1330KeywordsBacterial culturesBlindnessDementiaDisclosureEye diseasesGlaucomaInflammationSigns and symptomsUveitisVision ePublished: 15 June 2021 Issue Published: September 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...