Background Coronavirus disease-19 (COVID-19) is an infectious respiratory disease caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). Respiratory symptoms and flu-like presentation are the most defined clinical manifestations. However, gastrointestinal symptoms with acute abdomen have been reported in a small percentage, occasionally mimicking acute appendicitis. Hence, the diagnosis of COVID-19 should be suspected and investigated in every case of acute abdomen in the present situation. Case presentation We report a case of a 25-year-old male who presented with features of acute appendicitis. Despite the equivocal ultrasound results, he was scheduled for an emergency appendectomy for Alvarado’s score 7 out of 10, who underwent a successful appendectomy. The patient had initially tested negative on an upper respiratory COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) with normal chest X-ray but few hours after the surgery patient developed a high-grade fever. An RT-PCR for COVID-19 was resent following a suspicion that came out to be positive. Clinical discussion Several case reports have suggested a probable association between COVID-19 and appendicitis. This case shows the limited effectiveness of clinical diagnosis for the surgical abdomen in COVID-19 patients as these two conditions share similar symptoms often needing a clinical vigilance. Conclusion This case reports acute appendicitis in a patient who tested positive for SARS-CoV-2 subsequently following emergency appendectomy highlighting the acute gastrointestinal presentation of COVID-19. This case exemplifies the necessity to be familiar with the gastrointestinal symptoms of COVID-19 and maintain a high level of suspicion for COVID-19 infection in cases of abdominal pain. Highlights • Acute appendicitis can be one of the presentation of COVID-19. • Clinicians need to be familiar with the gastrointestinal symptoms of COVID-19. • Rapid diagnosis of COVID-19 in patients with acute abdominal pain should be done to prevent the virus from spreading. • A negative RT-PCR for COVID-19 can’t totally exclude COVID-19.
【저자키워드】 COVID-19, abdominal pain, Case report, Appendicitis, Appendectomy, 【초록키워드】 SARS-CoV-2, Symptom, surgical, RT-PCR, virus, clinical manifestations, Acute appendicitis, Corona, COVID-19 infection, clinical, Fever, Respiratory disease, male, Patient, Effectiveness, Rapid, chest X-ray, respiratory, Clinical diagnosis, association, COVID-19 patient, positive, abdomen, negative RT-PCR, Gastrointestinal symptom, Prevent, feature, upper respiratory, defined, tested, caused, reported, investigated, condition, suggested, maintain, highlighting, mimicking, diagnosis of COVID-19,