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CF possible?

Question
Hello,
my daughter is 14 months old and has, after a severe infection with RS virus at the age of 9 weeks, persistent bronchial problems, she gets an inhalative steroid and montelukast permanently. In the last 2 months she had two times a bronchitis and 2 pneumonias short after the other that had been treated in hospital. She is of normal height and weight for her age. She has 3-4 times stool per day, often with rests of the meal in the stool, what I associate however with the lack of chewing due the missing teeth. Now 2 sweat tests had been done, the first value was 53 and the second value at the second test 40. My question is, is the illness of CF excluded?
Many thanks for your answer!
Answer
Hello,
the infection with RS virus is unfortunately for the bronchi a severe infection that has long term consequences. In general, a bronchial hypersensitivity will stay for some years. This is for sure uncomfortable for your child, as CF has not yet been excluded.
Before: the treatment with an anti-inflammatory and anti-obstructive drug in form of inhalation is very good and necessary and over tíme also effective.
The borderline sweat test values cannot exclude the illness of CF.
The following investigations are necessary according to my opinion:
. measurement of pancreatic elastase
. x-ray of the lung in an infect-free interval
. mutation analysis
. probably electrophysical investigations (Hannover or Berlin, Germany)
. counselling in a certified CF center

Best regards,
Dr. H.-E. Heuer
12.05.2017