Concurrent Resolution of Chronic Diarrhea Likely Due to Crohn's Disease and Infection withMycobacterium avium paratuberculosis.
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 ofMycobacterium avium paratuberculosis(MAP), the causative agent of Johne's disease in cattle.MAPwas cultured from the stool. Biotyping of the bacterium isolated from cultures of stool demonstrated, it was the Indian Bison biotype ofMAP, 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 ofMAPin his stool. This patient is the first case shown to shedMAPfrom the stool who was cured of infection with antibiotics and who was concurrently cured of clinical signs of CD.
Microbiology Laboratory, Animal Health Division, Central Institute for Research on Goats , Mathura , India.
Shoor V
SV
Singh
Temple University Hospital , Philadelphia, PA , USA.
J Todd
JT
Kuenstner
Microbiology and Pathology, Washington State University , Pullman, WA , USA.
William C
WC
Davis
Department of Medicine, S.N. Medical College , Agra , India.
Prabhat
P
Agarwal
Microbiology Laboratory, Animal Health Division, Central Institute for Research on Goats , Mathura , India.
Naveen
N
Kumar
State Animal Husbandry Department , Kumher , India.
Devendra
D
Singh
Microbiology Laboratory, Animal Health Division, Central Institute for Research on Goats , Mathura , India.
Saurabh
S
Gupta
Microbiology Laboratory, Animal Health Division, Central Institute for Research on Goats , Mathura , India.
Kundan K
KK
Chaubey
Division of Animal Science, Krishi Bhavan (ICAR) , New Delhi , India.
Ashok
A
Kumar
Division of Animal Science, Krishi Bhavan (ICAR) , New Delhi , India.
Jyoti
J
Misri
Amity Institute of Microbial Technology, Amity University Jaipur , Jaipur , India.
Sujatha
S
Jayaraman
Amity Institute of Microbial Technology, Amity University Jaipur , Jaipur , India.
Jagdip S
JS
Sohal
Department of Pathology, Indian Veterinary Research Institute , Bareilly , India.
Kuldeep
K
Dhama
Crohn’s disease; ELISA; IS900 PCR and IS1311 PCR_RE; Mycobacterium avium paratuberculosis; antibiotic therapy; stool culture and microscopy for MAP