Extraintestinal manifestations of Crohn’s disease are rare but should be considered in patients with newly discovered lesions in organs not typically affected by inflammatory bowel disease (IBD). Here, we describe a case of a patient who presented with abdominal pain due to splenic lesions, with incidental discovery of pulmonary nodules. The patient was also found to have methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia on presentation, raising initial concern for septic emboli to the lungs and spleen. However, the patient’s abdominal pain did not improve, and the splenic lesions and pulmonary nodules increased in size despite appropriate antibiotic therapy, prompting evaluation for an alternative diagnosis. After further workup and multidisciplinary discussion, the patient was started on corticosteroids for suspected extraintestinal Crohn’s disease, with rapid clinical improvement. This case highlights the importance of reconsidering the differential diagnosis when a presumed etiology and its treatment do not explain the clinical course, and it reviews the literature on pulmonary nodules and splenic lesions as rare extraintestinal manifestations of Crohn’s disease.
Varghese et al. (Sat,) studied this question.