Meningitis due to cerebrospinal fluid leak after nasal swab testing for COVID‐19

Alberola‐Amores, Francisco Jose; Valdeolivas‐Urbelz, Enrique; Torregrosa‐Ortiz, Marta; Álvarez‐Sauco, Maria; Alom‐Poveda, Jorge

A 41 year-old woman presented to the Emergency department (ED), in October 2020, with holocraneal headache worsened by position changes and fever up to 37,7ºC, that started the 12 prior hours. She had no medical history of cephalea, visual loss or traumatic brain injury, not other secondary causes of CSF fistula. The patient had completed a nasal RT-PCR COVID-19 testing in March 2020 which came back negative. One week after, she developed unilateral continuous rhinorrhea with metallic taste. She was then diagnosed of allergic rhinitis by her general practitioner, who prescribed antihistaminics and a short-term antibiotherapy (Amoxicillin-Clavulanic), with no resolution of the symptoms. In July 2020 a nasal drainage tested positive for β2-transferrin and a head-CT was performed identifying a cerebrospinal fluid (CSF) fistula at the lamina cribrosa.