IS CROHN'S DISEASE A MYCOBACTERIAL DISEASE'! The fact that the
differential diagnosis of inflammatory bowel disease includes intestinal
infections has been a source of much interest and clinical concern for
many years. Since the recognition of ulcerative colitis and Crohn's
disease as clinical entities, numerous attempts have been made to
identify a specific organism resulting in the clinical and pathologic
picture of Inflammatory Bowel Disease. The first suggestion about a
connection between Johne's disease, a chronic mycobacterial enteritis in
cattle, and Crohn' s disease occurred in 1913, when Dalziel described
enteritis in humans which, although resembling intestinal tuberculosis,
he believed to be a new disorder. Since the work of Crohn in the
thirties a few investigators attempted to look for mycobacteria in
Crohn's disease. Until now the work of Van Patter, Burnham and others
did not receive widespread recognition. In 1984 the isolation of M.
paratuberculosis was reported by Chiodini et al. This report initiated
the current interest and controversy about a mycobacterial etiology in
Crohn's disease. The hypothesis "Crohn's disease is Johne's disease" did
not receive widespread recognition, but has lead to the first
muIticentered efforts to determine whether or not mycobacteria are
associated with Crohn's disease.