An Atypical Presentation of COVID-19 in a Previously Healthy Young Male With a Rare Cause of Abdominal Pain

Bashari, Daniel R.; Peguero-Tejada, Jennifer L.; Shah, Jigar I.

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by a newly discovered coronavirus that has reached pandemic proportions impacting millions globally. Authors feature an atypical case of COVID-19 presenting with a rare cause of abdominal pain and severe hyperglycemia. A 22-year-old male presented to the hospital with a 1-day history of severe abdominal pain. An abdominal computed tomography (CT) scan revealed findings of epiploic appendagitis (EA) and incidentally noted suspicious pulmonary lesions suggestive of COVID-19. Radiographic findings and distinctive laboratory results led to prompt testing by nasopharyngeal polymerase chain reaction (PCR), which ultimately confirmed the proposed diagnosis. Additionally, a significantly elevated hemoglobin A1c (HbA1c) signified undiagnosed diabetes mellitus. The patient was treated conservatively with supportive measures and made a full recovery. To our knowledge, this is the first case to describe how EA, a rare cause of abdominal pain, indirectly led to the diagnosis of COVID-19.