Jonathan Shapiro, also known as Zapiro, is known to be blessed with the ability of rustling political feathers through his sometimes caustic cartoons of public figures.

This time, the political satirist has unknowingly generated the ire of Twitter users through a widely-circulating doctored image of Jacob Zuma bent over in a doctor’s rooms. The cartoon bears his signature.

In the sketch, the doctor appears to be surprised as the scope reveals Zuma’s brain somewhere in his rectal area.

The original cartoon was of former US president George W. Bush and was published in 2002.

The original cartoon which first appeared in 2002

The original cartoon which first appeared in 2002

The doctored version first appeared several years ago and, even then, Zapiro had insisted it was a fake, in this article on his website.

“The font used for writing ZUMA’s is different to RECENT COLONOSCOPY” reads the article, referencing the image of Zuma coined by Zapiro with a showerhead attached to his head, after his notorious comments on taking a shower to avoid contracting HIV in 2006.

It’s unclear what caused the faked cartoon to re-appear but it went viral shortly after the presidency announced on Saturday that Zuma had been admitted into hospital.