Splenic Abscess: An Unusual Presentation of COVID-19?

Abstract

Most patients with coronavirus disease 2019 (COVID-19) present with respiratory symptoms that range from mild symptoms to severe illness leading to mortality. Some might be asymptomatic and others may present with unusual presentations. A 55-year-old male with a past history of ischemic stroke, ischemic heart disease, and type 2 diabetes mellitus presented with right-sided weakness and a history of abdominal pain, diarrhea, and fever. He tested positive for COVID-19. Computed tomography (CT) abdomen showed the presence of splenic abscess and small intraperitoneal gas indicating pneumoperitoneum. Laparotomy revealed ruptured splenic abscess and splenectomy was done. The patient continued to show features of severe sepsis with multiorgan failure and died on postoperative day 16. COVID-19 mainly affects the respiratory system but extrapulmonary affection has been reported. Direct invasion and damage to the organs by the virus could be the reason behind the development of the extrapulmonary manifestations.