| Popis: |
Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2. It often manifest with respiratory symptoms such as cough, fever, and difficulty in breathing. In addition to pulmonary involvement, COVID-19 is also associated with several extrapulmonary manifestations. The extrapulmonary pathology of COVID-19 could be due to either extrapulmonary dissemination of the virus and its replication, as has been observed for other zoonotic coronaviruses or widespread immunopathological complications of the disease. We report a case of an 18-year-old female who presented with persistent vomiting as the only presentation of COVID-19. Clinical evaluation including a battery of investigation such as hematological, biochemical, imaging, and endoscopy did not reveal any abnormality. However, her nasopharyngeal and nasal swab samples tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). We placed her on the approved COVID-19 regimen comprising lopinavir/ritonavir, zinc sulfate, hydroxychloroquine and azithromycin with augmentin, vitamin C, metoclopramide and intravenous fluid for one week. The vomiting subsided within 48-h of commencing the medications, and she became asymptomatic after 72-h. Repeat PCR after 12 days returned negative for SARS-CoV-2. This case report highlights the unusual clinical feature of COVID-19. It, therefore, underscores the need to thoroughly investigate symptomatic patients and also to optimize standard precaution as potentially infectious diseases such as COVID-19 may “masquerade” as a vague constitutional symptom(s). |
