COVID-19 nasal swab test caused brain fluid to leak from woman’s nose

When a woman became extremely sick after having surgery, no one could have imagined the cause was a standard nasal coronavirus test.

Anyone who has had a nasal coronavirus test will know it’s not pleasant.

But for one woman, the swab procedure turned out to be more than an uncomfortable tickle.

During a compulsory COVID-19 test as part of an elective hernia repair, her brain was ruptured by the long cotton bud used to collect and test for the virus.

This caused cerebrospinal fluid (CSF) – which is clear fluid that protects the brain and spinal cord – to leak.

The bizarre occurrence was only possible due to a rare and undiagnosed condition the woman had. Doctors in the US realised what had happened only after the woman, aged in her 40s, began complaining she was experiencing a runny nose, headache and neck stiffness.

She also had a metallic taste in her mouth and was suffering bouts of vomiting.

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A COVID-19 nasal swab test caused brain fluid to leak from woman’s nose. Picture: JAMA Otolaryngology/University of Iowa Hospitals and Clinics

CT scans documented in the JAMA Otolaryngology – Head and Neck Surgery journal showed a 1.8cm mass discovered inside her nose.

The mass turned out to be an encephalocele – a rare disorder where bones of the skull do not fuse completely. This creates a gap through which cerebral spinal fluid, brain tissue and the meninges (the membrane that covers the brain) can protrude into a sac-like formation.

The journal states the patient had likely had the condition for many years, but it had probably been misdiagnosed as sinus disease.

As a result, the unknowing health professional who administered the nasal swab to test for coronavirus had damaged this mass within her nose, causing the leakage of CSF.

The test punctured a sac in the woman’s nose, caused by a rare skull disorder. Picture: JAMA Otolaryngology/University of Iowa Hospitals and Clinics

If too much brain fluid leaks out, the brain sags inside the head, putting pressure on parts of the skull and causing headaches, a condition known as spontaneous intracranial hypotension, National Organisation for Rare Disorders states.

Thankfully, after doctors operated to reduce the mass, they were able to treat her undiagnosed condition with a soft skin graft and stop it protruding out of her skull.

“To our knowledge, this is the first report of an iatrogenic CSF leak after a nasal swab for COVID-19,” the report stated.

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