Lung function baby

Question

Dear expert team,

our little daughter is 4 months old and was diagnosed with CF. She is doing well and we are already going to a specialised outpatient clinic.

My question is: How is it possible to test the condition of the lung in such a young age in addition to a throat swab? And is it possible to find out if there are bacteria in the lung? Does the throat swab also give information about the colonisation of the bronchia and the lung?

Many thanks for your answer.

Answer

Hello,

Different examination methods can be applied in order to get a picture of the condition of a CF patient’s lung. These are, in general, the observation of respiration, auscultation of the lungs, an x-ray photograph or a CT or MRI examination of the lung, a lung function test, a bronchoscopy with bronchioalveolar lavage and a throat swab or examination of the sputum.
In your case with your young daughter only few of these examinations are justified. If your daughter was conspicuous because of having bronchitis or pneumonia it might make sense to do an x-ray photograph. Generally speaking it is possible to do a so called baby lung function at the age of four month. Not all CF centers are able to do this. If you child does not show any conspicuity with regards to the lung it is not necessary to do this test. The same applies for bronchoscopy and lavage. In comparison to the throat swab the status of colonisation of the lung with bacteria can be judged significantly safer by means of a lavage. However, such a bronchoscopy and lavage is not justified for a child without pathological findings and a course without complications. Regarding the results of the throat swab the following has to be considered. If the result is positive, i.e. if a germ is proven it can be assumed almost certainly that it will have effects on the airways. If the findings are negative, i.e. if no germs are proven the informative value is not that high. In such a case the sputum result is of higher value. However, your child is too young to cough up sputum and it is also very likely that the lungs are too good so that there is no production of sputum going on. In the age of your child one has to consider primarily the clinical picture and then decide which diagnostic measures are necessary and do make sense. If the breathing is calm and almost without cough it is sufficient to have the auscultation of the lungs and the throat swab. If the blood values show in addition to that that there is no focus of inflammation in the body one can put the mind at rest.
We wish you and your child all the best,

Dr. H.-G. Posselt

16.06.2010