ABSTRACT
BACKGROUND: The most used method to detect coronavirus disease 2019 during the pandemic is reverse transcriptase-polymerase chain reaction with nasal swab. Despite being highly effective, the test does not leave the patient risk-free and can lead to serious complications. These can be traumatic nasal cerebrospinal fluid (CSF) fistula and its consequences, such as meningitis. OBSERVATIONS: In this article, the authors present 4 case reports and a literature review. The following MeSH terms in the research were used: "CSF leak case report and covid 19." Six results were found and after searching the references and keywords 16 articles were identified. By using them, the authors tried to clarify the etiology of the fistula, its influences, and complications. LESSONS: The authors conclude that professionals must receive training, since CSF fistula originates from technical failure and lack of anatomical knowledge. The diagnosis cannot be neglected because it can bring complications to the patient's health.
ABSTRACT
BACKGROUND: Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests for COVID-19, which was treated with endoscopic endonasal repair. OBSERVATIONS: A 41-year-old man presented with clear continuous rhinorrhea through his left nostril for 5 days after repeated nasal swabbing for COVID-19. There were no obvious risk factors for spontaneous CSF leak. Computed tomography cisternography showed contrast accumulation in the left olfactory fossa and along the left nasal cavity. Such findings aligned with a preliminary diagnosis of CSF leakage through the left cribriform plate. Magnetic resonance imaging confirmed the presence of a CSF fistula between his left cribriform plate and superior nasal concha. The patient underwent endoscopic endonasal repair. CSF rhinorrhea ceased after the surgery, and no recurrence was noted during the 12-week postoperative follow-up period. LESSONS: Although rare, iatrogenic CSF leakage can be a serious complication following COVID-19 nasal swab tests, especially when infection may cause significant neurological sequelae. Healthcare providers should become familiar with nasal cavity anatomy and be well trained in performing nasal swab tests.
ABSTRACT
BACKGROUND: There are more than 206 million confirmed cases of Covid-19 infection globally. Nasopharyngeal swab testing is one of the widely used diagnostic methods for the initial diagnosis of such cases. With the growing diagnostic testing capacity, it is expected to observe an increased number of adverse events due to nasopharyngeal testing. CLINICAL PRESENTATION: A middle-aged woman presented with unilateral rhinorrhea, started after nasopharyngeal swab test for Covid-19. She had no prior medical issues. Thorough examination and imaging showed the presence of cerebrospinal fluid leakage. CONCLUSION: Nasopharyngeal swab testing may lead to serious complications and taking a brief history might be helpful. Also, patients should be educated on different complications of nasopharyngeal swab testing and their associated symptoms.