Hussain Mohammed Hassan, Siddiqui Saad, Mahmood Sara, Valsamakis Theodoros
Department of ENT, University Hospitals of Leicester NHS Trust, Leicester, UK
Department of ENT, University Hospitals of Leicester NHS Trust, Leicester, UK.
BMJ Case Rep. 2020 Aug 27;13(8):e237787. doi: 10.1136/bcr-2020-237787.
We report the case of a bronchial foreign body, following a tracheostomy site swab for SARS-CoV-2, aiming to raise awareness and vigilance. A qualified nurse was performing a routine SARS-CoV-2 swab on a 51-year-old woman, fitted with a tracheostomy in the recent past following a craniotomy. This was part of the discharging protocol to a nursing home. During the sampling, part of the swab stylet snapped and was inadvertently dropped through the tracheostomy site. Initial CT imaging was reported as showing no signs of a foreign body but some inflammatory changes. Bedside flexible endoscopy through the tracheostomy site revealed the swab in a right lobar bronchus. This was subsequently removed by flexible bronchoscopy. This case highlights the need for clear guidance on how samples for SARS-CoV-2 are taken from patients with front of neck airways (laryngectomy/tracheοstomy) and the potential pitfalls involved.
我们报告了一例在为新冠病毒进行气管造口部位拭子采样后出现支气管异物的病例，旨在提高认识和警惕性。一名合格护士正在为一名51岁女性进行常规新冠病毒拭子采样，该女性近期因开颅手术而进行了气管造口术。这是转至疗养院出院流程的一部分。采样过程中，拭子探针的一部分折断，不慎通过气管造口部位掉落。最初的CT影像报告显示没有异物迹象，但有一些炎症变化。通过气管造口部位进行的床边柔性内镜检查发现拭子位于右叶支气管。随后通过柔性支气管镜将其取出。该病例凸显了对于如何从颈部前方气道（喉切除术/气管造口术）患者采集新冠病毒样本需要有明确指导以及其中存在的潜在风险。
