Recurrent pneumonia from an ileobronchial fistula complicating Crohn's disease

We report the case of a patient with Crohn's disease and recurrent pneumoni a 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 sign s of pulmonary consolidation that fail to respond completely to antibiotic therapy. Mixed enteric nora is cultured from sputum and bronchial washings in most cases. Bronchoscopy findings range from chronic bronchial inflammat ion to feculent material in the airways. Barium enema is often diagnostic. Surgery and Crohn's-specific therapy are key components of curative therapy .