Discussion

Even though children with DS are more prone to infections (often originating in the respiratory tract) due to several predisposing factors, this inquiry concludes that the pathogens encountered in bronchoalveolar lavage fluids are similar compared to controls. Most frequently, cultures showed growth of typical bacteria such as Haemophilus influenza, catarrhalis species and Streptococcus pneumoniae in both groups. This was also the case in several studies of children with protracted bacterial bronchitis . The previously mentioned case reports about atypical pathogens in DS therefore seem to be rather exceptional. When treating patients with DS and (chronic) lower airway infections, antibiotic therapy should not necessarily be adjusted to a more broad spectrum than in children without underlying conditions. However, the multiple comorbidities in these patients and at times atypical or more severe course of infections vindicate a thorough evaluation and adequate treatment.