Differential diagnostic challenges during the Covid-19 pandemic for
pediatricians in an Eastern European country where newborn screening of
cystic fibrosis is not available: A case report
Abstract
Newborn screening (NBS) of cystic fibrosis (CF) is not available
currently in Hungary. Pediatricians should be able to recognize the
illness based on the symptoms alone. Lack of NBS causes differential
diagnostic challenges for physicians and delayed diagnosis of CF. We
present a case of a two-year-old girl who was transferred to our
hospital as a suspected Covid-19 patient with one week history of fever
and coughing in March 2020. As Covid-19 was excluded, the severity of
the clinical picture pointed towards an acute exacerbation of an
underlying chronic condition. Her symptoms such as tachypnea, wheezing,
lung crackles, hepatomegaly and clubbing of the fingers were all
consistent with undiagnosed CF. In the end, sweat chloride level and
genetic test verified the diagnosis. This case emphasizes the need of
NBS in Hungary.