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Recurrent Pneumonia from an Ileobronchial Fistula Complicating Crohn's Disease

Gumbo, Tawanda M.D.; Rice, Thomas W. M.D.; Mawhorter, Steven M.D.

Journal of Clinical Gastroenterology: April 2001 - Volume 32 - Issue 4 - pp 365-367
Brief Case Reports

We report the case of a patient with Crohn's disease and recurrent pneumonia for over 3 years before the discovery of an occult ileopulmonary fistula and review five other cases in the literature. Patients often present with chronic cough productive of feculent sputum, pleuritic chest pain, and signs of pulmonary consolidation that fail to respond completely to antibiotic therapy. Mixed enteric flora is cultured from sputum and bronchial washings in most cases. Bronchoscopy findings range from chronic bronchial inflammation to feculent material in the airways. Barium enema is often diagnostic. Surgery and Crohn's-specific therapy are key components of curative therapy.

From the Departments of Infectious Disease (T.G., S.M.) and Thoracic Surgery (T.W.R.), The Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.

Address correspondence and reprint requests to Dr. Steven Mawhorter, The Cleveland Clinic Foundation, Department of Infectious Disease, S32, 9500 Euclid Avenue, Cleveland, Ohio 9500, U.S.A.

© 2001 Lippincott Williams & Wilkins, Inc.