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At birth, Baby Joe appeared to be a normal, healthy baby boy. Both of his parents were in their late twenties and were healthy as well.

At birth, Baby Joe appeared to be a normal, healthy baby boy. Both of his parents were in their late twenties and were healthy as well.

At birth, Baby Joe appeared to be a normal, healthy baby boy. Both of his parents were in their late twenties and were healthy as well. At four weeks of age, Joe developed a middle-ear infection (called otitis media).  He suffered from recurrent ear infections over the next three months, which required antibiotic treatment.
Joe’s pediatrician recommended placing tubes in Joe’s ears to provide drainage of the fluid resulting from the infections. Cultures of the drainage fluid showed the presence of Haemophilus influenza, a pathogen commonly found in ear infections in infants.

Starting at three months of age, Joe had four bouts of diarrhea which persisted for 3-5 days each time. Joe also was not gaining weight as rapidly as was expected during this time. This reduced weight gain and growth is referred to as “failure to thrive.”

When Joe was four months old, he developed another ear infection, this one more severe than the previous infections. Joe’s parents took him to see his pediatrician, Dr. Smith. During the visit, Joe’s mother mentioned that when changing the baby’s diapers she had noticed an unusual, unpleasant odor to his urine.  Dr. Smith ordered the culture of the fluid draining from Joe’s ears. This time, the ear drainage fluid cultures
revealed the presence of Pseudomonas aeroginosa, a bacterium that is not typically present in infant ear infections. In addition, Dr. Smith determined that Joe was also suffering from a bladder infection, which caused an unpleasant odor in his urine.
Questions

  1. Given the information presented above, what do you suspect is the underlying cause or causes of Joe’s health problems? Do you think the cause is genetic, environmental, or both?
  2. How might these health problems cause Joe’s slow weight gain (also called “failure to thrive”)?

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