The authors present the case of an 18-year-old girl with cystic fibrosis. Her genotype was F508/N1303K. She had sputum colonisation by Pseudomonas aeruginosa and Staphylococcus aureus and since 2006, she also had Burkholderia cepacia in sputum, which was typed as genomovar II ( Burkholderia multivorans ). Her lung function had remained stable but low over the last few years despite complex psychosocial problems and issues with treatment compliance. She deteriorated at the end of May 2010 and was admitted with …