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Pseudomonas

Question
Hi,

I am 25 years old and have very severe asthma which is but difficult to be hold at bay with all drugs available (Symbicort, Singulair, Decortin 7,5mg, Sultanol forte for Pari boy...)
I permanently have infections and I had three bouts of pneumonia within a bit more of one year. Now an examination of the sputum showed that I have Pseudomonas within my bronchus. Kann this occur whith asthma also? How does such a colonisation with Pseudomonas happen? Many tests are being done at the moment. Is it possible that a person has asthma and cystic fibrosis at the same time? But in my age (I always had problems with my lung, but always asthma)? Is it possible that pseudomonas causes the frequent bouts of pneumonia? Also my lung function keeps being restricted.

Greetings,
Answer
Hi,

Pseudomonas is a typical germ with cystic fibrosis indeed, but it is not found there exclusively. We can detect that germ especially with chronic colonisation and/or infection of the airways, however, additionally mostly always a clear damage in the bronchus or the mucosa of the airways can be found. Thus for example bronchiectasia (bronchial enlargement, protrusion) – however they emerged – are a typical reason for pseudomonas. But pseudomonas is also a well-known hospital germ, that is a germ, which survives well in an hospital environment, and then may cause infections like pneumonia in patients who are hospitalized because of quite different matters.Further it is imporant to notice that the examination of sputum leads to reliable conclusions about the germs which actually prevail in the lung only under very certain conditions (for example with cystic fibrosis). In culture peudomonas grows so well, that other more important germs sometimes are overlooked in the sputum. Therefore utmost attention is necessary, and perhaps extraction of a sample from the lung itself (bronchoscopy) is required.
Now to your specific questions:
Yes, pseudomonas may occur in patients with asthma also.
Pseudomonas favours areas where it is moist (washbasin, shower, also soil), so you can catch it anywhere.
Having problems with asthma as well as symptoms of the typical CF lung disease does not yet mean that this person has both diseases. There is more to cystic fibrosis than the lung disease. But there are special situations with cystic fibrosis which are in accordance with asthma. Here the allergic bronchopulmonary aspergillosis (ABPA) is to mention which exists independent of cystic fibrosis.
Pseudomonas may cause pneumonia (see above).

With kind regards
Prof. Dr. TOF Wagner
22.12.2008