- Patient’s summarized time line.
| Relevant past medical history and interventions | |||
|---|---|---|---|
| An 8-year-old girl with CF (delF508/delF508, pancreatic insufficiency, and chronic P. aeruginosa colonization) and FMF (M694V/M694V) | |||
| Dates | Summaries from initial and follow-up visits | Diagnostic testing | Interventions |
| March 1, 2021 | Start to have fever, cough, and increased sputum. Hospitalization and initiation of treatment for acute pulmonary exacerbation of cystic fibrosis. | Infiltration on chest radiography. P. aeruginosa growth in sputum culture. | IV piperacillin-tazobactam and IV amikacin treatment were initiated. |
| March 13, 2021 | New onset of fever, hypoxia, and deterioration in general condition one day after dental intervention. | COVID-19 PCR test negative. S.epidermidis isolated in blood culture. | IV teicoplanin and IV meropenem were initiated. |
| March 14, 2021 | Patient diagnosed with MAS. | Anemia hyperferritinemia. Hypofibrinogenemia. Elevated transaminases. | IV pulse methylprednisolone 30 mg/kg/day for 3 consecutive days was initiated. |
| March 29, 2021 | Clinical improvement was observed. Patient was discharged after 2 weeks. | Laboratory tests returned to reference ranges. | Corticosteroid therapy was gradually tapered over a period of 3 months. |
CF: cystic fibrosis, FMF: familial Mediterranean fever, IV: intravenous, COVID-19: coronavirus disease 2019, MAS: macrophage activation syndrome, PCR: polymerase chain reaction, P. aeruginosa: Pseudomonas aeruginosa, S.epidermidis: Staphylococcus epidermidis