Case report: Epistaxis after Covid swab

Epistaxis is the spontaneous escape of blood from one or both nostrils. This is usually caused by injury to a blood vessel or extensive mucosal bleeding. Bleeding can often be caused by mechanical trauma, increased pressure in the vessels, dryness of the mucous membrane, coagulation disorders, systematic diseases of the blood picture, or a combination of these factors. Epistaxis can stop spontaneously, but can also be life-threatening or fatal. We report on an 86-year-old multimorbid patient who was presented to the ambulance because of an epistaxis. The patient was earlier hospitalized in a geriatric facility due to acute pneumonia and was receiving antibiotics and prophylactic anticoagulant therapy. In the emergency room we saw a hypertensive patient in reduced general condition with a left-sided, massive epistaxis after receiving a Covid swab. The source of the bleeding could not be localized and the Hemostasis could not be achieved either with bilateral tamponade or with an epistaxis catheter, so that surgical hemostasis had to be performed. Bleeding from the sphenopalatine artery was identified intraoperatively and stopped using monopolar coagulation. Postoperatively, the patient was monitored in intensive care and the further course was uncomplicated. In order to avoid such situations is necessary that care attendants to be instructed on the anatomical structures of the inner nose and trained on how to carry out the Covid swabs correctly.

Publication History

Article published online:
12 May 2023