COVID-19 presenting as severe, persistent abdominal pain and causing late respiratory compromise in a 33-year-old man.

Abstract

A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew Yersinia enterocolitica He recovered following supportive management and treatment with piperacillin-tazobactam.

• Authors: Sarah Catherine Walpole, Rebecca McHugh, Julie Samuel, Matthias Ludwig Schmid
• Journal: BMJ case reports (BMJ Case Rep) Vol. 13 Issue 6 (Jun 16 2020) ISSN: 1757-790X [Electronic] England
• PMID: 32546557 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Anti-Bacterial Agents
• Piperacillin, Tazobactam Drug Combination

Topics

• Abdominal Pain (diagnosis, etiology)
• Adult
• Anti-Bacterial Agents (administration & dosage)
• Betacoronavirus (isolation & purification)
• COVID-19
• Coronavirus Infections (diagnosis, physiopathology, therapy)
• Critical Care (methods)
• Diagnosis, Differential
• Diarrhea (diagnosis, etiology)
• Humans
• Lung (diagnostic imaging)
• Male
• Pandemics
• Piperacillin, Tazobactam Drug Combination (administration & dosage)
• Pneumonia, Viral (diagnosis, etiology, physiopathology, therapy)
• SARS-CoV-2
• Sputum (microbiology)
• Tomography, X-Ray Computed (methods)
• Treatment Outcome
• Yersinia enterocolitica (isolation & purification)