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COVID-19 infection - exclusive gastrointestinal symptoms

Case contributed by Edgar Lorente
Diagnosis almost certain


Presents to the primary care center with a week of diarrhea, fever and malaise. No respiratory symptoms reported. Blood test only shows high CRP. A chest x-ray is performed.

Patient Data

Age: 75 years
Gender: Male

Multiple faint alveolar opacities are identified, predominantly peripheral with greater involvement of the upper lobes. 

Case Discussion

Although the initial clinical suspicion was gastroenteritis in this case, after the radiological findings PCR was requested for SARS-CoV-2, which was positive.

We present this case of coronavirus infection to highlight presentation with only gastrointestinal symptoms. Recently, more cases have been reported in which these symptoms (diarrhea, nausea, vomiting, fever) precede the respiratory symptoms 2.

In this case, we show how in these situations the chest x-ray can raise the possibility of COVID-19 infection, allowing early diagnosis and predictably a better outcome.

Epidemiological context and high clinical suspicion are fundamental aspects for proper diagnosis, so radiologists must be familiar with these subtle findings in plain radiography to contribute to the best possible care in these patients.

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