Tuberculosis is an adverse event in patients with
Crohn's disease receiving anti-
tumor necrosis factor (TNF)
therapy. However,
tuberculosis presenting as a bronchoesophageal
fistula (BEF) is rare. We report a case of
tuberculosis and BEF in a patient with
Crohn's disease who received anti-TNF
therapy. A 33-year-old Korean woman developed
fever and
cough 2 months after initiation of anti-TNF
therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with
aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was
tuberculosis. Anti-
tuberculosis medications were administered, and esophageal
stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe
inflammation, a second esophageal
stent and
gastrostomy tube were inserted. Nine months after the diagnosis, the
fistula disappeared without recurrence, and the esophageal
stent and
gastrostomy tube were removed.