Background: Cerebrospinal fluid (CSF) rhinorrhea is a potentially life-threatening condition and it is a rare emergency presentation. Most cases have been related to head trauma. However, CSF leak post COVID swab has been rarely reported. Case Presentation: We report a 10-year-old male, who presented to emergency department complaining of unilateral clear watery nasal discharge for 14 days, the discharge started after COVID-19 nasopharyngeal swab. The patient was a known case of Malpuech-Michels-Mingarelli-Carnevale syndrome and had undergone surgical repair for cleft lip and cleft palate. From the history and physical examination, CSF rhinorrhea was highly suspected and nasal endoscopy confirmed the diagnosis of cribriform defect on the left side. The patient underwent surgical repair and the symptoms resolved after the surgery. Conclusion: COVID-19 nasopharyngeal swab can cause potential life-threatening complications and one should consider the contraindications and the alternative methods available to detect COVID-19 to minimize the potential risks.

Keywords: Covid-19, rhinorrhea, CSF leak, Swab, PCR