Crohn's disease with intracranial Mycobacterium Iranian infection in children with gastrointestinal bleeding as the first symptom: a case report

Abstract

Abstract Background: Nontuberculosis mycobacteria are prone to infect patients with immunodeficiency or immunosuppressive diseases. There have been reports of Crohn's disease in the intestine combined with gastrointestinal bleeding, but there have been no reports of gastrointestinal bleeding in Crohn's children with intracranial Mycobacterium Iranian infection. Patient presentation: A 10-year-old Chinese boy developed fever and gastrointestinal bleeding. A continuous decrease in hemoglobin leads to shock. Surgical pathology confirmed Crohn's disease. In addition, Mycobacterium Iranian infection was detected in his cerebrospinal fluid through metagenomic next-generation sequencing (mNGS). Therefore, after surgical resection of the bleeding intestine, the patient received antituberculosis treatment for intracranial infection, followed by full screening for latent tuberculosis infection (LTBI) and regular treatment with biological agents. Conclusion: A boy with Crohn's disease and gastrointestinal bleeding was diagnosed with intracranial Mycobacterium Iranian infection. It is emphasized that when Crohn's disease is complicated by gastrointestinal bleeding, surgery combined with biological agent therapy should be considered to save lives and reduce the risk of recurrent bleeding. Postoperative caution should be exercised against opportunistic infections and the appropriate use of anti-tuberculosis drugs.