Shrateh Oadi N, Abugharbieh Yazan, Al-Fallah Orwa
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Deparment of Radiology, Al-Ahli Hospital, Hebron, Palestine.
Int J Surg Case Rep. 2023 Jul;108:108402. doi: 10.1016/j.ijscr.2023.108402. Epub 2023 Jun 16.
The nasopharyngeal swab, which has experienced a marked increase in utilization during the COVID-19 pandemic and is considered the gold standard for COVID-19 testing due to its high diagnostic accuracy and sensitivity, The procedure is generally safe and well-tolerated, with pain, discomfort, and the urge to cough or sneeze being the most common complications. Though it is occasionally associated with serious complications.
we report two cases of brain abscess as a complication of nasopharyngeal COVID-19 testing. The first case was of a 47-year-old male diabetic patient with a positive medical history for immune thrombocytopenic purpura (ITP) who developed a frontal brain abscess one week after the swabbing procedure and was treated with systemic antibiotics followed by a successful functional endoscopic sinus surgery. The second case involved a hypertensive female patient in her 40s who also developed a frontal brain abscess on the same side as painful nasal COVID-19 testing. Systemic antibiotics were used to treat the patient.
Serious adverse events from nasopharyngeal COVID-19 testing were reported to occur rarely, with incidences ranging from 0.0012 to 0.026 %. Retained swabs, epistaxis, and CSF leakage were commonly reported complications, which were frequently associated with high-risk factors such as septal deviations, pre-existing basal skull defects, and sinus surgeries. However, brain abscess complications are considered one of the extremely rare complications, with only a few cases reported in the literature.
Appropriate approaches that depend on adequate anatomical knowledge are necessary for practitioners to perform nasopharyngeal COVID-19 testing.
鼻咽拭子在新冠疫情期间的使用量显著增加，因其诊断准确性和敏感性高，被视为新冠病毒检测的金标准。该操作一般安全且耐受性良好，疼痛、不适以及咳嗽或打喷嚏的冲动是最常见的并发症。不过，它偶尔也会引发严重并发症。
我们报告两例因新冠病毒鼻咽检测引发脑脓肿并发症的病例。首例为一名47岁男性糖尿病患者，有免疫性血小板减少性紫癜（ITP）病史，在拭子采样操作一周后发生额叶脑脓肿，接受全身抗生素治疗，随后成功进行了功能性鼻内镜鼻窦手术。第二例涉及一名40多岁的高血压女性患者，在进行痛苦的新冠病毒鼻咽检测后，同侧也发生了额叶脑脓肿。对该患者使用了全身抗生素进行治疗。
据报道，新冠病毒鼻咽检测引发的严重不良事件很少发生，发生率在0.0012%至0.026%之间。拭子残留、鼻出血和脑脊液漏是常见的并发症，这些并发症常与鼻中隔偏曲、既往颅底缺损和鼻窦手术等高危因素相关。然而，脑脓肿并发症被认为是极其罕见的并发症之一，文献中仅报道了少数病例。
从业者进行新冠病毒鼻咽检测时，需要依靠充分的解剖学知识采取适当的方法。
