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Unusual presentation of more common disease/injury
CASE REPORT
Colobronchial fistula: a rare cause of non-resolving pneumonia in Crohn’s disease
  1. Karim El-Hag1,
  2. Pietro Renzulli2,
  3. Daniel Franzen3,
  4. Malcolm Kohler3
  1. 1Department of Internal Medicine/Pulmonology, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
  2. 2Department of Surgery, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
  3. 3Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
  1. Correspondence to Dr Karim El-Hag, dr.karim.elhag{at}gmail.com

Summary

We discuss the case of a 44-year-old man with a refractory left lower lobe pneumonia progressing to a pulmonary abscess caused by a colobronchial fistula, a rare complication of underlying Crohn’s disease. The patient presented with weight loss and signs of a pulmonary consolidation, which responded incompletely to the targeted antibiotic treatment. The causative colobronchial fistula was demonstrated by CT-guided puncture and retrograde injection of contrast medium. After fistula excision, the patient recovered rapidly with a weight gain of 4 kg within a few weeks.

  • crohn’s disease
  • pneumonia (respiratory medicine)

https://doi.org/10.1136/bcr-2018-224408

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    Footnotes

    • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. KE is the principal author and contributed to the conception and writing of this article as well as acquisition and review of all cited literature, acquisition and edition of the included figures. PR contributed to the critical revision of the article. DF was involved in the discussion of planning the article and revision of the article. MK was responsible for the final approval of this published version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer Each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in the BMJ.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.