# COVID-19 Infection in a Patient With Sigmoid Diverticulitis: Viral Diverticulitis or Incidental Association?

## TL;DR

A woman with diverticulitis developed a persistent fever, later found to be caused by a coinciding COVID-19 infection.

## Contribution

This case emphasizes the need to consider viral infections like COVID-19 when treating patients with diverticulitis and unexplained fever.

## Key findings

- A patient with acute sigmoid diverticulitis developed persistent fever and was later diagnosed with SARS-CoV-2.
- The patient's symptoms improved after completing antibiotic therapy and with the resolution of the viral infection.
- The case suggests the importance of testing for viral infections in patients with treatment-resistant fever.

## Abstract

This report describes the case of a previously healthy 54-year-old woman who presented with acute sigmoid diverticulitis. Outpatient treatment with ciprofloxacin and metronidazole was initiated. After four days of starting on antibiotics, she returned to the hospital with medication-resistant fever and worsening abdominal discomfort, prompting admission. Intravenous therapy with appropriate antibiotics (ceftriaxone and metronidazole) was initiated, but the fever recurred, suggesting possible treatment failure. On the fourth day of hospitalization, with the onset of mild respiratory symptoms (mild rhinorrhea and nasal voice), a respiratory viral panel was performed, which tested positive for SARS-CoV-2. The patient showed progressive clinical improvement and was discharged after completion of antibiotic therapy. This case highlights the importance of considering viral infections, including COVID-19, in the differential diagnosis of persistent fever during the treatment of diverticulitis.