People who have had extensive sinus or skull base surgery should consider oral tests, experts say. (File)
Washington:
Covid-19 nasal swab test ruptured the lining at the base of an American’s skull, causing cerebrospinal fluid to leak from her nose and putting her at risk of brain infection, medics reported in a newspaper medical Thursday.
The patient, who is in her 40s, had a rare, undiagnosed disease and the test she received may have been done incorrectly, an unlikely sequence of events that means the risk of nasal tests remains very low.
But healthcare professionals should be careful to follow testing protocols closely, Jarrett Walsh, lead author of the JAMA Otolaryngology-Head & Neck Surgery article, told AFP.
People who have had extensive sinus or skull base surgery should consider ordering oral tests if available, he said.
“This underscores the need for proper training of those performing the test and the need for vigilance after the test is performed,” added ear, nose and throat specialist Dennis Kraus, of Lenox Hill Hospital in New York, which was not involved in the paper.
Walsh, who practices at the University of Iowa Hospital, said the woman went for a nasal test before elective hernia surgery, and then noticed clear fluid coming out from one side of her nose.
She then developed headaches, vomiting, a stiff neck and an aversion to light, and was transferred to Walsh’s care.
“She had already been swabbed for another procedure, on the same side, no problem. She feels like the second swab was maybe not using the best technique and the entrance was a bit high,” a- he declared.
In fact, the woman had been treated years earlier for high intracranial pressure – meaning the pressure of the cerebrospinal fluid that protects and nourishes the brain was too high.
Doctors at the time used a shunt to drain some of the fluid, and the disease resolved.
But that led to her developing what’s called an encephalocele, or a defect at the base of the skull that pushed the lining of the brain out into the nose where it was likely to rupture.
This went unnoticed until the old scans were reviewed by her new doctors, who performed surgery to repair the defect in July.
She has since made a full recovery.
Walsh said he believed the symptoms she developed were the result of irritation to the lining of the brain.
If the problem had not been treated, she could have developed a life-threatening brain infection from bacteria traveling up her nose.
Most testing protocols require clinicians to follow the path of the floor of the nose, which is above the roof of the mouth, rather than pointing the swab up – or if they are pointing it up. , to do so with great care.
Walsh said that while it was likely a very rare event, it was a reminder of the need for high quality training, given that hundreds of millions of additional tests will be done before it is over. of the pandemic.
(Except for the title, this story was not edited by GalacticGaming staff and is posted from a syndicated feed.)
