The woman complained of a runny nose, headache and neck stiffness after a Covid-19 test. Images / JAMA Otolaryngology / University of Iowa Hospitals and Clinic
Anyone who has had a nasal coronavirus test will know it's not pleasant.
But for one US 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 protects the brain and spinal cord, to leak.
The bizarre occurrence was only possible because of 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.
CT scans documented in the JAMA Otolaryngology – Head and Neck Surgery journal showed a 1.8cm mass 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 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 unwitting health professional who administered the nasal swab to test for coronavirus had damaged this mass within her nose, causing the leakage of CSF.
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, the 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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