Cystic fibrosis (CF) is a disease caused by a mutation in the cystic fibrosis 
transmembrane conductance regulator protein in the epithelial membrane, and 
affects at least 30,000 people in the USA. There are between 900 and 1000 new 
cases diagnosed every year. Traditionally, CF has been treated symptomatically 
with pancreatic enzymes, bronchodilators, hypertonic saline, and pulmozyme. In 
July 2015, the US Food and Drug Administration approved Orkambi 
(lumacaftor/ivacaftor), a combination drug that works on reversing the effects 
of the defective cystic fibrosis transmembrane conductance regulator protein. 
Orkambi and mucolytics decrease the viscosity of mucous secretions, leading to 
an accumulation of hypoviscous fluid in the alveoli, resulting in dyspnea. This 
presentation can be mistaken for an infective exacerbation. We present a case in 
which a young female with CF recently started on Orkambi therapy presented to 
her primary care physician with dyspnea and increased respiratory secretions and 
was admitted to the hospital for 2 weeks of intravenous and inhaled antibiotic 
therapy for a presumed CF exacerbation. We highlight this case to bring 
awareness and educate patients and clinicians of the side-effect profile of 
Orkambi therapy with an intent to avoid unnecessary hospitalizations, inpatient 
antibiotics, and other costly medical services.