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Reminder of important clinical lesson
Case report
Tracheal swab from front of neck airway for SARS-CoV-2; a bronchial foreign body
  1. Mohammed Hassan Hussain,
  2. Saad Siddiqui,
  3. Sara Mahmood and
  4. Theodoros Valsamakis
  1. Department of ENT, University Hospitals of Leicester NHS Trust, Leicester, UK
  1. Correspondence to Mohammed Hassan Hussain; mohammed.hussain{at}doctors.org.uk

Abstract

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.

  • otolaryngology / ENT
  • radiology
  • medical-surgical nursing
  • ear
  • nose and throat/otolaryngology

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

http://dx.doi.org/10.1136/bcr-2020-237787

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    Footnotes

    • Contributors MHH: conception of idea and drafting of the manuscript. SS and SM: literature review and drafting the manuscript. TV: review of the final manuscript.

    • Funding University Hospitals of Leicester NHS Trust (866108).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.