Question Melissa, a 12-year-old girl with cystic fibrosis comes to the primary care office with complaints of increased cough and productive green sputum over the last week. She also complains of increasing shortness of breath. She denies sore throat or nasal congestion. On physical examination, her temperature is 101 and she has inspiratory wheezes bilaterally. Negative lymphadenopathy noted. The posterior pharynx is pink without exudate. BP 112/72 HR 96 RR 28. 1. In cystic fibrosis, the airway microenvironment favors bacterial colonization. In a minimum of 150 words explain the pathophysiological reason for this occurrence

Why the Airway Microenvironment Favours Bacterial Colonization in Cystic Fibrosis

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The respiratory system harbors bacteria and can be easily infected by both positive and negative bacteria. According to Pellicciotta et al. (2019), although some respond positively to antibiotics, others and harsh and quickly mutate to develop an immunity against antibiotic therapy. These prove to be lethal to the body’s immune system and risk the patient’s health, and in some cases, may cause death. For example, cystic fibrosis is a chronic autosomal recessive respiratory health disease caused by bacteria in the lungs. It is considered a severe disease common in white people in western countries, and once diagnosed, patients have a short lifespan if not well taken care of.

Why the Airway Microenvironment Favours Bacterial Colonization in Cystic Fibrosis

Cystic Fibrosis (CF) is considered a lung disease. The bacterial inflation causes severe inflammation of several body organs, mainly the lungs; this inflammatory response acts as a course for other symptoms to follow through and is the main cause of death. The most common bacteria in the lungs found to cause CF is Pseudomonas Aeruginosa (Farrell et al., 2017). The growth and colonization of lungs are made possible by this bacterium’s stubborn ability to overrun the immune response of the lung tissue. The inflammatory response triggers an overproduction of periciliary fluid. Together will overhydration of mucus lowers the mucociliary clearance, presenting the organ with an infection. After the initial infection, an excessive and bloated inflammatory response leads to the system’s inability to fight off this infection; hence, the lungs cannot eradicate this infection. Unless a cure is introduced early enough, this bacterium persists and mutates in the airways.

References
Farrell, P. M., White, T. B., Ren, C. L., Hempstead, S. E., Accurso, F., Derichs, N., … & Sosnay, P. R. (2017). Diagnosis of cystic fibrosis: consensus guidelines from the Cystic Fibrosis Foundation. The Journal of pediatrics, 181, S4-S15.
Pellicciotta, M., Rigoni, R., Falcone, E. L., Holland, S. M., Villa, A., & Cassani, B. (2019). The microbiome and immunodeficiencies: lessons from rare diseases. Journal of autoimmunity, 98, 132-148.

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