本文分析了惠普尔养障体感染所致儿童重症肺炎的临床特点，旨在提高儿科医师对该病的认识及诊治水平。回顾性分析柳州市人民医院2020—2021 年收治的2例重症惠普尔养障体肺炎患儿的临床资料，并对国内外相关文献进行复习。患儿1为女性，3岁5个月；患儿2为男性，5月龄。患儿临床表现均以发热、咳嗽、气促为主，C反应蛋白及降钙素原均升高，计算机体层扫描均提示肺部有不同程度斑片影、支气管充气征。采用病原微生物宏基因组二代测序技术对患儿的肺泡灌洗液进行检测，病例1的样本中检出金黄色葡萄球菌及惠普尔养障体，病例2的样本中检出惠普尔养障体及鲍曼不动杆菌。2例病例均予以呼吸机辅助通气，给予美洛培南联合复方磺胺甲恶唑抗感染治疗，最后均好转出院。结果表明，惠普尔养障体感染可致婴幼儿发生重症肺炎，临床以发热、咳嗽、气促为主要表现，可合并其他病原菌感染，应尽早采用病原微生物宏基因组二代测序技术检测病原体，以明确诊断并及时给予针对性抗感染治疗。

This study analyzed the clinical characteristics of severe pneumonia in children caused by Whipple disease to enhance pediatricians’ understanding and treatment of this condition. A retrospective analysis was conducted on the clinical data of two cases of severe Whipple disease-related pneumonia admitted to Liuzhou People’s Hospital from 2020 to 2021, along with a review of relevant domestic and international literature. Patient 1 was a female aged 41 months, Patient 2 was a male aged 5 months. Both patients presented primarily with fever, cough, and shortness of breath. C-reactive protein and procalcitonin levels were elevated in both cases, and computed tomography scans indicated varying degrees of patchy shadows and bronchial wall thickening in the lungs. Metagenomic next-generation sequencing was performed on the bronchoalveolar lavage fluid of the patients. In sample 1, Staphylococcus aureus and Tropheryma whipple were detected, while sample 2 revealed Tropheryma whipple and Acinetobacter baumannii. Both patients received assisted ventilation via a ventilator and were treated with a combination of meropenem and sulfamethoxazole-trimethoprim for infection. Both patients eventually improved and were discharged. The results indicate that Whipple disease can cause severe pneumonia in infants and young children, primarily presenting with fever, cough, and shortness of breath, and may be associated with other bacterial infections. It is crucial to employ metagenomic next-generation sequencing technology for pathogen detection early on to confirm the diagnosis and provide timely targeted anti-infection treatment.