Concurrent Resolution of Chronic Diarrhea Likely Due to Crohn's Disease and Infection with Mycobacterium avium paratuberculosis

• Published in: Frontiers in medicine 2016-10, Vol.3, p.49
• Main Authors: Singh, Shoor V, Kuenstner, J Todd, Davis, William C, Agarwal, Prabhat, Kumar, Naveen, Singh, Devendra, Gupta, Saurabh, Chaubey, Kundan K, Kumar, Ashok, Misri, Jyoti, Jayaraman, Sujatha, Sohal, Jagdip S, Dhama, Kuldeep
• Format: Article
• Language: English
• Subjects: Antibiotic therapy; Crohn’s Disease; ELISA; IS900 PCR and IS1311 PCR_RE; Medicine; Mycobacterium avium paratuberculosis; stool culture and microscopy for MAP
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2016.00049

Examination of samples of stool from a 61-year-old male patient, presenting with the clinical symptoms of Crohn's disease (CD), revealed massive shedding of acid fast bacilli with the morphology of ( ), the causative agent of Johne's disease in cattle. was cultured from the stool. Biotyping of the bacterium isolated from cultures of stool demonstrated, it was the Indian Bison biotype of , the dominant biotype infecting livestock and humans in India. Based on this finding and because the patient was unresponsive to standard therapy used in India to treat patients with gastrointestinal inflammatory disorders, the patient was placed on a regimen of multi-antibiotic therapy, currently used to treat tuberculosis and CD. After 1 year of treatment, the patient's health was restored, concurrent with cessation of shedding of in his stool. This patient is the first case shown to shed from the stool who was cured of infection with antibiotics and who was concurrently cured of clinical signs of CD.