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Published on: February 29, 2020
[CEREBROSPINAL FLUID (CSF) LEAK FOLLOWING COVID-19 NASAL SWAB: A CASE REPORT]
Roee Noy1, Arie Gordin1, Moni Benifla2
1Department of Otolaryngology - Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel, The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Insights
A rare cerebrospinal fluid leak can occur after COVID-19 nasal swabs. Proper technique is crucial to prevent this serious complication and potential infections like meningitis.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Background:
- The COVID-19 pandemic necessitated widespread diagnostic testing, including nasal swabs.
- Standard COVID-19 testing methods involve various nasal specimen collections.
- While generally safe, nasal swabs carry a risk of skull base injury and cerebrospinal fluid (CSF) leak.
Observation:
- A case study details a five-year-old girl experiencing CSF rhinorrhea post-COVID-19 nasal swab.
- Symptoms included headache and unilateral metallic-tasting nasal discharge, worsened by forward bending.
Findings:
- Cerebrospinal fluid rhinorrhea is a rare but serious complication of nasal swab procedures.
- Prompt recognition is vital due to risks of meningitis, brain abscess, sepsis, and mortality.
Implications:
- Highlights the importance of correct nasal swab technique to minimize patient risk.
- Emphasizes the need for awareness among healthcare providers regarding potential complications.
- Underscores the necessity of prompt diagnosis and management of CSF leaks following nasal procedures.
Introduction:
Coronavirus 19 (Covid-19) emerged as a global pandemic with over 12,900 deaths in Israel alone. On average, more than 40,000 tests to detect the virus daily were performed in Israel. According to the US Centers for Disease Control and Prevention (CDC), the recommended methods for testing are nasopharyngeal swab, mid-turbinate, or anterior nasal swab specimen. Although these methods are generally safe, they are not without risks. Particularly, traumatic or improperly angled test may injure the skull base and lead to a cerebrospinal fluid leak. This rare condition presents with headache, unilateral nasal discharge with a metallic taste, and is aggravated when bending forward. It is essential to recognize this condition since there is an increased risk of meningitis, brain abscess, sepsis, and death. In addition, one should know how to perform nasal swab tests to avoid this complication. This paper presents a case of a five-year-old girl diagnosed with cerebrospinal fluid rhinorrhea following a nasal swab test for Covid-19. In addition, a summary of the clinical, radiological and treatment aspects was prepared.
