Pseudomonas

Question

My son is 4,5 years old and is sensitive to bronchitis and bronchiolitis since he was one year old. Recently he was detected with pseudomonas. His case does not appear to be cystic fibrosis, since he is a very tall and heavy child (118 cm tall – weighs 27 kg). The results from the amniocentesis during the pregnancy and from the screening test after birth were negative for CF. Despite all this, we are going to recheck the sputum culture and I believe the results will be positive for pseudomonas again (we are still waiting) and the doctor urges us to do a sweat test. How worried should we by the presence of pseudomonas in the lungs in a person without CF? Our doctor recommends a bronchoscopy but I have reservations. Thank you.

Answer

Dear friend,
During the pregnancy you did an amniocentesis but you do not clarify if the embryo was checked for CF mutations specifically. You did an IRT test to the newborn which came out negative.
If there is pseudomonas in the lungs, a sweat test is necessary, but also a check to exclude other pathological conditions, in which pseudomonas develops in sputum cultures, such as immunodeficiency, dyskinetic cilia syndrome etc.
In a healthy organism (without CF, immunodeficiency, dyskinetic cilia syndrome) the presence of pseudomonas in the lungs is unimportant and is expected to go away.
I do not know your case in detail, but I cannot see any reason for the bronchoscopy, nor the possible diagnostic information it may offer in respect to the investigation of the possibility of CF.
Yours friendly,
Dr. Stavros Doudounakis

25.03.2013