After getting a coronavirus swab test at a hospital, a U.S. woman began leaking brain fluid from her nose, according to a study published Thursday in the Journal of the American Medical Association.
When the woman later returned to the hospital, complaining of headaches, neck stiffness, light sensitivity, and a persistent metallic taste in her mouth, the doctors behind the study began investigating.
Though nasal swab testing for COVID-19 is well-known for causing discomfort, the 40-something woman’s experience is the first known case of its kind, according to the study’s authors — and it took an unusual set of circumstances to happen.
The strange symptoms were new to her, but it wasn’t the first time she had taken a nasal swab test, Jarrett Walsh, the paper’s senior author and University of Iowa Hospital physician, told Agence France-Presse.
“She had been swabbed previously for another procedure, same side, no problems at all,” he said. “She feels like maybe the second swab was not using the best technique, and that the entry was a little bit high.”
Doctors soon discovered she had a rare undiagnosed condition, encephalocele. The base of her skull wasn’t completely closed, causing her brain to protrude outward, leaving it exposed to any long, probing object.
“The swab itself did not result in a violation of the bony skull base, but rather the invasive test caused trauma to the patient’s preexisting encephalocele,” the study said.
The condition, which doctors believe had gone undetected since 2017, likely stemmed from previous operations and procedures to relieve intracranial hypertension — when the pressure of the fluid surrounding the brain is too high.
A look into the woman’s medical history revealed she also had a surgery to remove nasal polyps 20 years prior, according to the study.
She has since been treated for her latest medical issue, including surgery to repair her skull, and has recovered, AFP reported.
While cases like this are rare, they highlight the importance of proper training and preparation for coronavirus testing, the authors said, particularly in light of plans to significantly increase testing capacity by the end of the year.
“As the number of daily COVID-19 nasal and nasopharyngeal swab specimen collection procedures increases, a greater burden is placed on the health care system to properly train clinicians and even the general public to safely perform nasal and nasopharyngeal swab testing,” the study said.
The authors added that, so far, complications caused by nasal testing have not been “well described in the existing literature.”