ABSTRACT
The nasopharyngeal swab has been used with increased frequency since the beginning of the COVID-19 pandemic. Little has been written in the literature regarding the complications arising from this procedure, as it is generally accepted as safe. In this report, we describe a case in which a young woman sustained a traumatic skull base injury during a nasopharyngeal swab for COVID-19. We then discuss the subsequent treatment and outcome. This case demonstrates the potential for significant complications arising from this widespread procedure and the necessity for awareness of these potential complications. Laryngoscope, 131:1927-1929, 2021.
Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Cerebrospinal Fluid Leak/etiology , Encephalocele/etiology , Skull Base/injuries , Adult , Encephalocele/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Nasopharynx , Skull Base/diagnostic imaging , Skull Base/surgery , Tomography, X-Ray ComputedABSTRACT
SARS-CoV-2 infection has been associated with ischemic stroke as well as systemic complications such as acute respiratory failure; cytotoxic edema is a well-known sequelae of acute ischemic stroke and can be worsened by the presence of hypercarbia induced by respiratory failure. We present the case of a very rapid neurologic and radiographic decline of a patient with an acute ischemic stroke who developed rapid fulminant cerebral edema leading to herniation in the setting of hypercarbic respiratory failure attributed to SARS-CoV-2 infection. Given the elevated incidence of cerebrovascular complications in patients with COVID-19, it is imperative for clinicians to be aware of the risk of rapidly progressive cerebral edema in patients who develop COVID-19 associated acute respiratory distress syndrome.