Nikhil Prasad Fact checked by:Thailand Medical News Team Feb 03, 2026 1 hour, 42 minutes ago
Medical News: Acute diverticulitis is a common condition that causes abdominal pain and fever, especially in middle aged and older adults. It occurs when small pouches in the colon become inflamed or infected. Normally, antibiotics lead to steady improvement. However, new findings suggest that when fever persists despite correct treatment, the cause may not always be worsening gut disease. In some cases, a hidden viral infection such as COVID-19 may be responsible. This
Medical News report highlights a recent clinical study that sheds light on this overlooked diagnostic challenge.
New research shows COVID-19 can silently prolong fever in diverticulitis patients, confusing diagnosis and
treatment decisions.
A Confusing Clinical Picture
The study focused on a 54-year-old woman who arrived at hospital with left sided abdominal pain and fever. Imaging scans showed uncomplicated sigmoid diverticulitis, a condition usually treated successfully with oral antibiotics. Despite following standard treatment, the patient returned days later with persistent fever and worsening discomfort, raising concerns about treatment failure or serious complications such as abscess or perforation.
Doctors admitted her for intravenous antibiotics and close monitoring. Although her abdominal pain improved, her fever continued daily, creating uncertainty for the medical team. Repeat scans ruled out worsening diverticulitis, leaving physicians searching for another explanation.
COVID-19 Emerges as the Hidden Trigger
During her hospital stay, the patient developed mild respiratory symptoms including a runny nose and nasal speech. This prompted testing for respiratory viruses. Results confirmed infection with SARS-CoV-2, the virus responsible for COVID-19. Interestingly, once the viral diagnosis was made, her fever resolved rapidly without the need for specific antiviral treatment. She recovered fully and was discharged in stable condition.
This case demonstrates how COVID-19 can coexist with other illnesses and alter their clinical course. The virus is now known to affect the digestive system in many patients, sometimes causing fever and abdominal pain even in the absence of cough or breathing difficulty.
Why COVID-19 Can Mimic Abdominal Disease
Researchers explain that SARS-CoV-2 can infect cells in the gut and disrupt normal intestinal function. It may also trigger inflammation, disturb gut bacteria, and cause tiny blood vessel injuries. These effects can prolong fever and inflammation, making it appear that antibiotics are not working when, in fact, a viral infection is driving symptoms.
Studies suggest that up to one fifth of COVID-19 patients experience digestive symptoms. In rare cases, the virus can imitate conditions such as appendicitis, colitis, or diverticulitis, leading to diagnostic confusion.
Institutions Behind the Research
The researchers involved in this study are from the Hospital Alemão Oswaldo Cruz a
nd the Oswaldo Cruz German Hospital in São Paulo Brazil. Departments included Internal Medicine and Nephrology, reflecting a multidisciplinary effort to understand the overlap between infectious diseases and gastrointestinal conditions.
Key Clinical Lessons
The study stresses that persistent fever during diverticulitis treatment does not always mean antibiotic failure. Doctors should continue to rule out serious abdominal complications using appropriate imaging. However, they should also consider viral infections, especially during periods of widespread respiratory illness or when mild respiratory symptoms appear.
Recognizing viral coinfection early may help avoid unnecessary antibiotic escalation, invasive procedures, or prolonged hospital stays, improving patient safety and outcomes.
Conclusions
This study highlights an important and timely lesson for both doctors and patients. Persistent fever in diverticulitis should not automatically be seen as a sign of worsening disease. COVID-19 and other viral infections can quietly coexist, prolonging fever and altering expected recovery patterns. Awareness of this possibility allows for more balanced decision making, avoids overtreatment, and supports safer care. As viral illnesses continue to circulate globally, clinicians must remain alert to atypical presentations that cross traditional disease boundaries.
The study findings were published in the peer reviewed journal: Cureus.
https://www.cureus.com/articles/449048-covid-19-infection-in-a-patient-with-sigmoid-diverticulitis-viral-diverticulitis-or-incidental-association#!/
For the latest COVID-19 news, keep on logging to Thailand
Medical News.
Read Also:
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/articles/long-covid
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