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Case report
Microbial clues lead to a diagnosis of cystic fibrosis in late adulthood
  1. Colm Kerr1,
  2. David Morrissy2,3,
  3. Mary Horgan4 and
  4. Barry J Plant2,3
  1. 1School of Medicine, Trinity College Dublin Faculty of Health Sciences, Dublin, Ireland
  2. 2HRB Clinical Research Facility, University College Cork, Cork, Ireland
  3. 3Department of Respiratory Medicine, Cork University Hospital Group, Cork, Ireland
  4. 4Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
  1. Correspondence to Professor Barry J Plant; b.plant{at}


Cystic fibrosis (CF) is the most common life-limiting autosomal recessive genetic disorder among Caucasian populations. The majority of CF cases are diagnosed in childhood; however, increasing numbers of adults are being diagnosed with the condition. We present the case of a 65-year-old Irish woman presenting with a chronic cough and a history of recurrent respiratory tract infections. Staphylococcus aureus, Scedosporium apiospermum and Stenotrophomonas maltophilia were grown from bronchoalveolar lavage raising suspicion for CF. Sweat testing was negative; however, genetic testing revealed the presence of ∆F508 and R117H CF mutations, the latter mutation conferring a milder form of CF. The patient commenced treatment with the cystic fibrosis transmembrane conductance regulator (CFTR) potentiator medication ivacaftor to good effect. Novel CFTR potentiators and modulators have significant potential to benefit morbidity and mortality in this group. In this case, the microbiological results were key in pursuing genetic testing and diagnosing CF.

  • respiratory system
  • infectious diseases
  • genetics
  • cystic fibrosis
  • respiratory medicine

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  • Contributors MH and BJP provided direction and planing for the case report submission. DM was involved in collating clinical data and images for the report as well as obtaining consent from the patient. The case report was compiled by CK and BJP. The case report was edited by all parties.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.