Background: Gastrointestinal (GI) symptoms have been widely reported as the initial manifestations of COVID-19; however, bloody diarrhea as a primary presentation was an atypical manifestation to be linked with COVID-19 infection. Nevertheless, immunocompromised patients might be presented with atypical clinical presentations.
Case Presentation: An unusual manifestation of bloody diarrhea in a post kidney transplant patient with recent novel COVID-19 infection was presented. The patient was presented to the emergency department with significant bloody diarrhea and other GI symptoms, including nausea and vomiting accompanied with fever, and dry cough, for the last 3 days. The patient denied of having any chest pain, shortness of breath, travel history, or close contact with any confirmed COVID-19 cases. The patient looked lethargic, conscious, and oriented. A chest examination revealed normal bilateral airway entry with no added sounds. The rest of the physical examination was unremarkable. A COVID-19 nasopharyngeal swab was obtained and came out positive.
Conclusion: This case of COVID-19 in a transplant patient raised the awareness and increased the index of suspicion for atypical manifestations, which could lead to missed or delayed diagnosis, hence worsening outcomes.
Key words: COVID-19, bloody diarrhea, gastrointestinal symptoms, case report
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