Atypical presentations of coronavirus disease 2019 in a patient with acute obstructive suppurative cholangitis

Clin Res Hepatol Gastroenterol. 2020 Nov;44(6):e135-e140. doi: 10.1016/j.clinre.2020.05.003. Epub 2020 May 21.


During the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak in Wuhan, China, we experienced a case of SARS-CoV-2 infection with atypical presentations in a patient with acute obstructive suppurative cholangitis (AOSC), who was initially admitted with jaundice and fever. The patient had no other typical symptoms of COVID-19 such as cough, dyspnea, nausea, vomiting, abdominal pain and diarrhea except for fever, but her epidemiological history was clear. COVID-19 was finally confirmed by repeated viral nucleic acid testing, but her repetitive lungs CT imaging findings had been atypical. After endoscopic-related operations and antiviral treatment, the patient was subsequently recovered and discharged. This particular case is being reported to provide a reference and guidance for the diagnosis and management of COVID-19 in AOSC.

Keywords: AOSC; Acute obstructive suppurative cholangitis; COVID-19; SARS-CoV-2.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease / epidemiology
  • Aged
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology*
  • COVID-19 Nucleic Acid Testing*
  • China / epidemiology
  • Cholangitis / diagnosis*
  • Cholangitis / epidemiology*
  • Cholangitis / surgery
  • Comorbidity
  • Female
  • Humans
  • RNA, Viral / analysis
  • SARS-CoV-2* / genetics


  • RNA, Viral