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

BMJ Case Rep. 2020 Jun 16;13(6):e236030. doi: 10.1136/bcr-2020-236030.


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.

Keywords: adult intensive care; infectious diseases; medical management; pneumonia (respiratory medicine); respiratory medicine.

Publication types

  • Case Reports

MeSH terms

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


  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination