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01.12.2015 | Case report | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

A case of failed eradication of cystic fibrosis-related sinus colonisation by Pseudomonas aeruginosa

Zeitschrift:
BMC Pulmonary Medicine > Ausgabe 1/2015
Autoren:
Barry Linnane, Linda Kearse, Nuala H. O’ Connell, John Fenton, Miranda G. Kiernan, Colum P. Dunne
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

BL, NO’C and JF were responsible for treatment of the patient. BL, NO’C and CD recognized the novelty of the Case and drafted the manuscript. LK and MK completed the microbiology analyses and drafted the manuscript. All authors read and approved the final manuscript.

Authors’ information

Not applicable.

Availability of data and materials

Not applicable.

Abstract

Background

Pseudomonas aeruginosa is a pathogen associated with cystic fibrosis that has potential to decrease lung function and cause respiratory failure. Paranasal sinuses are increasingly recognised as potential reservoirs for intermittent colonisation by P. aeruginosa. This case documents investigation and outcome of P. aeruginosa recurrence in a male paediatric patient over an eight year period.

Case presentation

A 12 year old Irish male paediatric cystic fibrosis patient experienced intermittent culturing of P. aeruginosa from the oropharyngeal region, indicating chronic infection of the sinuses despite absence of symptoms, retaining good lung function, and normal bronchoscopy and bronchoalveloar lavage. However, P. aeruginosa was isolated from a sinus wash-out and was identified as a unique strain of P. aeruginosa that was also cultured from cough swabs. Despite treatment, successful eradication from the paranasal sinuses was not achieved.

Conclusions

Few reports have addressed the paranasal sinuses as a reservoir for lung infection in cystic fibrosis patients despite increased recognition of the need to investigate this niche. In this case, attempts at eradication of P. aeruginosa present in paranasal sinuses including oral and nebulised antimicrobials proved unsuccessful. However, detection of P. aeruginosa in the paranasal sinuses instigated antimicrobial treatment which may have contributed to prevention of migration to the lower airways. Our outcome provides additional insight and may indicate utility of nasal lavage or nasal endoscopy in paediatric cystic fibrosis patients’ annual review clinic visits.
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