Mycobacterium avium subspecies paratuberculosis bacteremia in type 1 diabetes mellitus: an infectious trigger?

Mycobacterium avium subspecies paratuberculosis (MAP) is the established cause of paratuberculosis in ruminants (i.e., Johne disease). The bacterium is shed in the milk of infected cows and survives pasteurization. Recently, an association between MAP and Crohn disease has been suggested, wherein MAP has been found to persist in a cell wall–deficient form, escaping clearance by the host immune system.