Case report: Iatrogenic cerebral spinal fluid leak after nasopharyngeal swab for diagnosis of SARS-CoV-2

Authors

DOI:

https://doi.org/10.52076/eacad-v4i1.259

Keywords:

Spinal cerebrospinal fluid leak; Reverse transcriptase polymerase chain reaction; Iatrogenic disease; Sphenoid bone.

Abstract

The diagnosis of COVID-19 relies on different confirmatory tests. The gold standard test is the reverse transcriptase reaction followed by the polymerase chain reaction (RT-PCR) for SARS-CoV-2, using a nasopharyngeal swab. However, this test may present complications that request literature discussion, like the perforation of skull base bones with the clinical outcome of iatrogenic cerebral spinal fluid leak (CSF leak). This study aims to report the case of iatrogenic CSF leak as a consequence of a nasopharyngeal swab test used for research of SARS-CoV-2 in a patient with no previous history of anatomical anomalies of the skull base. The outcome of the case was surgical, with septoplasty and left ethmoid and sphenoid sinusotomy being performed. Consequently, there is a need to educate health professionals, especially regarding the right approach of the test, as well as the relevance of the patient's previous history regarding previous neurological and otorhinolaryngological conditions, in order to avoid iatrogenesis and possible complications.

References

Moazzam, M., Sajid, M. I., Shahid, H., Butt, J., Bashir, I., Jamshaid, M., Shirazi, A. N., & Tiwari, R. K. (2020). Understanding COVID-19: From Origin to Potential Therapeutics. International journal of environmental research and public health, 17(16), 5904. https://doi.org/10.3390/ijerph17165904

Johns Hopkins Coronavirus Resource Center. (2022). COVID-19 Map - Johns Hopkins Coronavirus Resource Center. Disponível em https://coronavirus.jhu.edu/map.html

Patel, A., Jernigan, D. B., & 2019-nCoV CDC Response Team (2020). Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020. MMWR. Morbidity and mortality weekly report, 69(5), 140–146. https://doi.org/10.15585/mmwr.mm6905e1

G1. (2022). Vacinação contra a Covid: 40% da população tomou a dose de reforço; mais de 57% das crianças tomaram a 1ª dose. Disponível em https://g1.globo.com/saude/coronavirus/vacinas/noticia/2022/04/28/vacinacao-contra-a-covid-40percent-da-populacao-tomou-a-dose-de-reforco-mais-de-57percent-das-criancas-tomaram-a-1a-dose.ghtml

Food and Drug Administration. (2022). COVID-19 Test Basics. Disponível em https://www.fda.gov/consumers/consumer-updates/coronavirus-disease-2019-testing-basics

Chau, C. H., Strope, J. D., & Figg, W. D. (2020). COVID-19 Clinical Diagnostics and Testing Technology. Pharmacotherapy, 40(8), 857–868. https://doi.org/10.1002/phar.2439

Paquin, R., Ryan, L., Vale, F. L., Rutkowski, M., & Byrd, J. K. (2021). CSF Leak After COVID-19 Nasopharyngeal Swab: A Case Report. The Laryngoscope, 131(9), 1927–1929. https://doi.org/10.1002/lary.29462

Holmes, A., & Allen, B. (2021). Case Report: An Intracranial Complication of COVID-19 Nasopharyngeal Swab. Clinical practice and cases in emergency medicine, 5(3), 341–344. https://doi.org/10.5811/cpcem.2021.5.52232

Rajah, J., & Lee, J. (2021). CSF rhinorrhoea post COVID-19 swab: A case report and review of literature. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia, 86, 6–9. https://doi.org/10.1016/j.jocn.2021.01.003

Samadian, M., Maroufi, S. F., Taheri, M. S., & Jafari, A. (2021). CSF rhinorrhea after nasopharyngeal swab testing for COVID-19: A case report and review of literature. Otolaryngology case reports, 21, 100370. https://doi.org/10.1016/j.xocr.2021.100370

Sullivan CB, Schwalje AT, Jensen M, et al. (2020). Cerebrospinal Fluid Leak After Nasal Swab Testing for Coronavirus Disease 2019. JAMA Otolaryngology Head and Neck Surgery, 146(12), 1179–1181. https://doi.org/10.1001/jamaoto.2020.3579

Koskinen A, Tolvi M, Jauhiainen M, Kekäläinen E, Laulajainen-Hongisto A, Lamminmäki S. (2021). Complications of COVID-19 Nasopharyngeal Swab Test. JAMA Otolaryngology Head and Neck Surgery, 147(7), 672-674. https://doi:10.1001/jamaoto.2021.0715

Tang R, Mao S, Li D, Ye H, Zhang W. (2021). Treatment and Outcomes of Iatrogenic Cerebrospinal Fluid Leak Caused by Different Surgical Procedures. World Neurosurgery, 143, e667-e675. https://doi:10.1016/j.wneu.2020.08.069

Brasil, Ministério da Saúde. (2022). Guia de vigilância epidemiológica: Emergência de saúde pública de importância nacional pela doença pelo coronavírus 2019. Editora MS. Disponível em https://www.gov.br/saude/pt-br/coronavirus/publicacoes-tecnicas/guias-e-planos/guia-de-vigilancia-epidemiologica-covid-19

Zanini, F. D., Lenoch, R. Y., Steiner, L. da S. P. O., Paes Junior, A. J. de O., & da Silva, A. H. (2021). Fístula Liquórica Espontânea: Relato De Caso. Arquivos Catarinenses De Medicina, 50(1), 144–150. https://revista.acm.org.br/index.php/arquivos/article/view/914

Published

30/01/2023

How to Cite

Zanúncio, A. V. ., Dugnani, G. B. ., Matias, J. M. C. ., Brasil, J. A. C. ., Martins, L. M. N. ., Camargos, N. B. de ., & Souza, P. M. de . (2023). Case report: Iatrogenic cerebral spinal fluid leak after nasopharyngeal swab for diagnosis of SARS-CoV-2 . E-Acadêmica, 4(1), e1141259. https://doi.org/10.52076/eacad-v4i1.259

Issue

Section

Health and Biological Sciences