UMMS Affiliation

Department of Otolaryngology Head and Neck Surgery; School of Medicine

Publication Date


Document Type

Case Study


Infectious Disease | Medical Education | Otolaryngology | Otorhinolaryngologic Diseases | Respiratory Tract Diseases | Virus Diseases


Nasopharyngeal swabs are commonly done in the medical field for a multitude of reasons, and they recently have been an essential component of widespread testing to control the spread of COVID-19. Although rare, improper technique when performing nasopharyngeal swabs has the potential to lead to injury or misleading test results. We present a case of uncontrolled epistaxis requiring hospitalization following a routine nasopharyngeal swab in a healthy patient. Both the complexity and variability of the anatomy of the nasopharynx can contribute to poor swabbing technique. Otolaryngologists should be encouraged to educate and support other healthcare workers to improve the yield and reduce the risk of harm due to nasopharyngeal swabs. Increased comfort levels with performing nasopharyngeal swabs will also improve the sensitivity of screening tests for common respiratory viruses such as influenza, Epstein-Barr virus (EBV), or bacteria such as Staphylococcus aureus.


COVID-19, Nasopharyngeal swab, Epistaxis, Education, Otolaryngology

Rights and Permissions

© 2021 Elsevier Inc. This is an open access article under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.

DOI of Published Version



Liu M, Roychowdhury P, Ito CJ. Role of the otolaryngologist in nasopharyngeal swab training: A case report and review of the literature. Otolaryngology Case Reports. 2021 May 18;20:100316. doi: 10.1016/j.xocr.2021.100316. View article at publisher's site

Journal/Book/Conference Title

Otolaryngology Case Reports

PubMed ID


Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.