scholarly journals Clinical Course of a Covid-19 Patient with Gastrointestinal Symptoms- A Case Report

2020 ◽  
Vol 8 (2) ◽  
pp. 148-151
Author(s):  
Sidra Agarwal ◽  
Hemanshi Mistry
Keyword(s):  
New York ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Respiratory Symptoms ◽  
Clinical Course ◽  
Gastrointestinal Symptoms ◽  
Oral Route ◽  
Nasopharyngeal Swab ◽  
Virus Shedding ◽  
Angiotensin Converting Enzyme 2

Background: COVID-19 most commonly presents with respiratory symptoms. However, it can involve the gastrointestinal tract causing symptoms like diarrhea and the resultant shedding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces. This is due to the virus adhering to angiotensin-converting enzyme 2 receptors largely present in the gastrointestinal tract. This case report recommends routine stool Real-Time Reverse Polymerase Chain Reaction (rRT-PCR) testing for patients presenting with gastrointestinal symptoms. The Case: A healthy 36-year-old male healthcare worker in New York who tested positive for SARS-CoV-2 infection through rRT-PCR of the nasopharyngeal swab. After 7 days of convalescence, he recovered from influenza like symptoms after which he predominantly developed diarrhea, nausea, vomiting and extreme fatigue. Cough was the only lower respiratory symptom during the 3rd week of the clinical course. Anosmia or ageusia preceding the onset of respiratory symptoms was also reported. Due to the outbreak of the pandemic and New York being the epicenter at the time, the patient was recommended to self-isolate with supportive management through antipyretics and electrolyte replacement. Conclusion: This case highlights a SARS-CoV-2 PCR positive patient with predominant gastrointestinal symptoms. The reports regarding virus shedding in feces suggest that SARS-CoV-2 could be transmitted via fecal-oral route and thus routine stool rRT-PCR testing can aid in transmission-based precautions. Furthermore, reports of viral ribonucleic acid present in the stool, suggests direct infectivity of the virus on the intestinal tract. Therefore, screening in patients with only gastrointestinal symptoms can potentially help to contain the virus spread.

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

scholarly journals Detection of influenza virus in rectal swabs of patients admitted in hospital for febrile illnesses in Thailand

2021 ◽  
Vol 9 ◽  
pp. 205031212198963
Author(s):  
Artit Sangkakam ◽  
Pasin Hemachudha ◽  
Abhinbhen W Saraya ◽  
Benjamard Thaweethee-Sukjai ◽  
Thaniwan Cheun-Arom ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Gastrointestinal Tract ◽  
Hospital Stay ◽  
Rectal Swab ◽  
Average Length ◽  
Gastrointestinal Symptoms ◽  
Virus Detection ◽  
Length Of Hospital Stay ◽  
Nasopharyngeal Swab ◽  
Influenza Virus Detection

Introduction: Influenza virus favours the respiratory tract as its primary site of host entry and replication, and it is transmitted mainly via respiratory secretions. Nasopharyngeal swab is the gold standard specimen type for influenza detection, but several studies have also suggested that the virus replicates in the human gastrointestinal tract. Methods: A retrospective study was conducted on all patients positive for influenza virus and initially recruited as part of the PREDICT project from 2017 to 2018. The objectives of the study were to investigate whether rectal swab could aid in improving influenza detection, and if there was any correlation between gastrointestinal disturbances and severity of infection, using length of hospital stay as an indicator of severity. Results: Of the 51 influenza-positive patients, 12 had detectable influenza virus in their rectal swab. Among these 12 rectal swab positive patients, influenza virus was not detected in the nasopharyngeal swab of three of them. Gastrointestinal symptoms were observed for 28.2% patients with a negative rectal swab negative and 25.0% patients with a positive rectal swab. Average length of hospital stay was 4.2 days for rectal swab positive group and 3.7 days for rectal swab negative group. This difference was not statistically significant (p = 0.288). Conclusions: There is no correlation between influenza virus detection in rectal swab and gastrointestinal disturbances or disease severity, and there is currently insufficient evidence to support replicative ability in the gastrointestinal tract.

scholarly journals Generalized tetanus in an 11-year-old boy: A case report

2021 ◽  
Vol 11 (1) ◽  
pp. 69-75
Author(s):  
Artem A. Kozlov ◽  
Irina V. Shevchuk ◽  
Aleksei E. Zavialov ◽  
Anatoly N. Emelyanov
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Gastrointestinal Tract ◽  
Pain Relief ◽  
Antibiotic Therapy ◽  
Clinical Course ◽  
Treatment Strategies ◽  
Adequate Pain Relief ◽  
Choice Of Treatment ◽  
Severe Tetanus

The study presents a case report of a generalized form of severe tetanus in an unvaccinated 11-year-old child. Pain and convulsive syndromes, respiratory failure, and damage to the gastrointestinal tract prevailed in the acute period. Antibiotic therapy, anti-tetanus serum, adequate pain relief, and anticonvulsant therapy were the leading treatments of the child. Moreover, the paper discusses literature data on the options for the clinical course and choice of treatment strategies. The lack of planned vaccination in children is unsafe.

scholarly journals COVID-19 gastrointestinal manifestation presenting as acute surgical like abdomen

2021 ◽  
Vol 8 (9) ◽  
pp. 2848
Author(s):  
Krishna Ramavath ◽  
Siddharth S. Rao ◽  
Nyna Sindhu ◽  
Tushar Parmeshwar ◽  
Pranay Palle
Keyword(s):  
Respiratory Symptoms ◽  
Rna Virus ◽  
Gastrointestinal Symptoms ◽  
Sudden Onset ◽  
Virus Protein ◽  
Loose Stool ◽  
Diagnostic Dilemma ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Gastrointestinal Manifestation

COVID-19 disease is caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) which can cause respiratory symptoms more. It can cause gastrointestinal symptoms also due to this RNA virus protein binding to the angiotensin converting enzyme 2 (ACE2) receptors which are abundantly present in stomach, small intestine, large intestine and liver. The gastrointestinal manifestations of COVID-19 disease can present as acute surgical abdomen which can create diagnostic dilemma. We presented a case of COVID-19 disease, admitted in our hospital. Later he had symptoms of acute surgical abdomen symptoms like sudden onset abdominal pain, nausea, vomiting and loose stool without blood. He was properly evaluated and conservatively managed. The gastrointestinal manifestations of COVID-19 disease can present as acute surgical abdomen. So, these patients properly evaluated and then only surgical plan will be made according pathology.

scholarly journals Ogilvie syndrome in a COVID-19 patient with pneumonia, absolute tachyarrhythmia and heart failure: A case report

2021 ◽  
Vol 52 (2) ◽  
pp. 160-164
Author(s):  
Zoran Matković ◽  
Nataša Đekić-Matković
Keyword(s):  
Heart Failure ◽  
Respiratory Symptoms ◽  
Fatal Outcome ◽  
Gastrointestinal Symptoms ◽  
Mucosal Immune Response ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Gastrointestinal Manifestations ◽  
Therapeutic Measures ◽  
Ogilvie Syndrome

The COVID-19 pandemic has recently spread worldwide presenting primarily in form of pneumonia. Gastrointestinal manifestations such as nausea, vomiting, diarrhoea and abdominal pain are less common than respiratory symptoms. However, critically ill patients may develop digestive complications including acute pseudo-obstruction of colon-Ogilvie syndrome. Gastrointestinal symptoms can manifest before the onset of typical respiratory symptoms. Common mucosal immune response underly both-pulmonary and gastrointestinal manifestations (high expression of angiotensin-converting enzyme 2 receptors). This article described a 75-year old female patient who arise Ogilvie syndrome during viral bilateral pneumonia induced by COVID-19. Patient also had an absolute tachyarrhythmia and hearth failure. Diameter of caecum, ascending and transverse colon was 12 to 14 cm. The walls of this segment of large bowel were deserosed, with threatening perforation. Right colectomy was performed. Nine days after the surgery, despite all therapeutic measures taken, there was a fatal outcome due to pulmonary thromboembolisation.

scholarly journals Prominent rash and multisystem inflammatory syndrome in a 29-year-old patient with COVID-19: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Catherine A. Gao ◽  
James M. Walter ◽  
Jane E. Dematte D’Amico
Keyword(s):  
Case Report ◽  
Respiratory Symptoms ◽  
Clinical Course ◽  
Adult Patients ◽  
Inflammatory Biomarkers ◽  
Case Presentation ◽  
Hispanic Patient ◽  
Mucosal Changes ◽  
Inflammatory Syndrome ◽  
Disease Present

Abstract Background Adult patients with coronavirus disease present primarily with respiratory symptoms, but children and some adults may display a more systemic inflammatory syndrome with rash, fever, mucosal changes, and elevated inflammatory biomarkers. Case presentation Here, we report the case of a 29-year-old Hispanic patient presenting with significant rash and multisystem inflammation. We describe his clinical course, review dermatological manifestations of coronavirus disease, and summarize the pathophysiology of coronavirus disease-associated multisystem inflammation. Conclusion This case should alert physicians to the atypical nature of presenting rash with minimal respiratory symptoms in coronavirus disease.

scholarly journals Covid-19 infection without respiratory symptoms: case report of diagnosing a 14 year-old patient with acute abdomen 

2020 ◽  
Author(s):  
Ladan Goshayeshi ◽  
Nasrin Milani ◽  
Robert Bergqueist ◽  
Sayyed Majid Sadrzadeh ◽  
Farnood Rajabzadeh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Respiratory Rate ◽  
Respiratory Symptoms ◽  
Free Fluid ◽  
Nasopharyngeal Swab ◽  
High Resolution Computed Tomography ◽  
Respiratory Involvement ◽  
Chest X Ray ◽  
Gastrointestinal Manifestation

Abstract Background. Coronavirus Disease 2019 (Covid-19) is expanding worldwide. Although it seems to be a purely respiratory disease, occasional reports of lesions in other organs have been published. We report here an asymptomatic child Covid-19 patient with the main symptom of abdominal pain distension and without any respiratory symptoms.Case presentation. A 14 year-old male patient without respiratory involvement but with main complaints of fever, malaise, anorexia, and severe abdominal pain was admitted to a hospital in Mashhad, Iran. Following general anaesthesia, laparotomy revealed distension of the small intestine and an adhesive ileo-caecal band that had produced ileum herniation without free fluid in the abdomen. The band was surgically severed and the patient referred to the recovery room. Because of pulse rate of 36-40 per min and respiratory rate of 140 and a saturated O2 of 86%, the patient was referred to the intensive care unit. Chest X-ray and high-resolution computed tomography of the lungs showed bilateral, diffuse, peripheral dense areas of ground-glass appearance. A nasopharyngeal swab for Covid-19 diagnosis, ordered due to lymphopenia together with these diffuse lung infiltrations, showed a positive result. This led to drug treatment with lopinavir/ritonavir, hydroxychloroquine, ribavirin/oseltamivir and meropenem. The patient was febrile and developed tachycardia on the third day accompanied with a respiratory rate of 44/min. At this point, tracheal intubation was done but the patient died after 3 hours due to cardiac arrest.Conclusions. The case report brings forth the hypothesis that the gastrointestinal manifestation may be untypical symptoms of Covid-19 infection, and highlights the importance for the diagnosis to be based on combined laboratory-based data and scanning imagery.

scholarly journals Isolated Gastrointestinal Metastasis of Breast Carcinoma: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
M. A. Titi ◽  
A. Anabtawi ◽  
A. D. Newland
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Breast Carcinoma ◽  
Cancer Metastasis ◽  
Gastrointestinal Symptoms ◽  
Metastatic Breast ◽  
Breast Cancer Metastasis ◽  
Hepatic Flexure ◽  
Breast Metastasis

Purpose. Gastrointestinal tract is one of the rare locations for breast cancer metastasis. This paper shows such metastasis may occur even in the absence of breast metastasis in other more common locations.Case Report. A 64-year old female was admitted to the hospital with abdominal discomfort and diarrhea. She had breast carcinoma treated 7 years previously with normal follow-up since. Colonoscopy showed hepatic flexure thickening that was confirmed to be breast metastasis. Staging investigations showed upper and lower gastrointestinal tract metastasis with negative findings elsewhere.Conclusion. Although more common causes for gastrointestinal symptoms should be excluded, however, a high index of suspicion of metastatic breast cancer is needed when such patients develop gastrointestinal symptoms.

scholarly journals A challenging case of COVID-19 infection presented with isolated acute abdominal pain: A case report and literature review

2021 ◽  
Vol 9 ◽  
pp. 2050313X2098321
Author(s):  
Mohammad Altermanini ◽  
Mhd Baraa Habib ◽  
Abdel-Naser Elzouki
Keyword(s):  
Infectious Disease ◽  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Respiratory Symptoms ◽  
Acute Abdominal Pain ◽  
Gastrointestinal Symptoms

COVID-19 is an infectious disease, which often presents with fever and respiratory symptoms. However, gastrointestinal symptoms have also been reported to occur in patients with COVID-19. Although abdominal pain was described in some reports of COVID-19, it was uncommon and often associated with other symptoms. We describe a challenging case of a COVID-19 patient who presented with severe isolated abdominal pain initially, then developed pneumonia symptoms which led to the diagnosis of COVID-19 thereafter.

scholarly journals Case Report: SARS-CoV-2 as an unexpected causal agent of isolated febrile hepatitis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 400
Author(s):  
Paraskevas Filippidis ◽  
Francois van Ouwenaller ◽  
Alberto Cerutti ◽  
Anaïs Geiger-Jacquod ◽  
Christine Sempoux ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Symptoms ◽  
Unknown Origin ◽  
Causal Agent ◽  
Nasopharyngeal Swab ◽  
Serological Testing ◽  
Case Presentation ◽  
Pcr Screening ◽  
Work Up

Background: Respiratory symptoms and pneumonia are the predominant features of Coronavirus disease 2019 (COVID-19) due to emerging SARS-CoV-2 virus, but extrapulmonary manifestations are also observed. For instance, some degree of liver injury has been described among patients requiring hospital admission for severe COVID-19. However, acute febrile hepatitis as an initial or predominant manifestation of COVID-19 has been rarely reported. Case presentation: A 34-year-old man without underlying medical conditions presented with fever of unknown origin for two weeks in the absence of respiratory symptoms or other complaints. Laboratory testing revealed isolated acute hepatitis, for which an extensive microbiological work-up did not reveal identification of the causal agent. PCR testing for SARS-CoV-2 on a nasopharyngeal swab was negative on two occasions and initial serology for SARS-CoV-2 (at 15 days from symptoms onset) was also negative. However, repeated SARS-CoV-2 serological testing at 30 days demonstrated seroconversion leading to the diagnosis of COVID-19-related hepatitis. The patient's condition progressively improved, while transaminases steadily declined and eventually returned back to normal within 30 days. Conclusions: We describe here a unique case of SARS-CoV-2 isolated febrile hepatitis in a young and previously healthy man, which was diagnosed by demonstration of seroconversion, while PCR screening was negative. This case report highlights the role of repeated serological testing for the diagnosis of extrapulmonary manifestations of COVID-19.

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