Four patients aged 30-34 years with Crohn's disease in and advanced stage, having lasted 2 or 3 years, were treated by several injections of 10mg lyophilized cell wall material of P. granulosum strain KP-45 locally into the lesion. In all 4 cases a preceding conventional therapy with Salazopyrine and Prednisone or surgery had been unsuccessful. This local immunomodulatory treatment led to decisive improvement of the disease in all 4 cases, in 3 cases inflammatory symptoms disappeared completely. For this reason a local immunomodulation with P. granulosum KP-45 is recommended as an additional therapeutic procedure in patients who are otherwise resistant to therapy.