Background: Herpes Zoster (HZ) also known as shingles is common dermatological pathology seen in in the emergency department. Multidermatomal involvement is an uncommon presentation and usually is linked to individuals with compromised immune systems. However it is rarely reported in the immunocompetent population. Case presentation: We report a 30-year-old Emirati male complaining of low-grade fever for 3 days, sore throat and discomfortable pruritic erythematous rash over his chest and back for 2 days. He was treated the day preceding his presentation in another facility for a presumed allergic reaction after taking ibuprofen. On physical examination, he was found to have exudative tonsillitis and Influenza and was treated for both and discharged. He returned again reporting increasing pain and was referred to be seen in the dermatology clinic where a biopsy was obtained and he was discharged with a steroid topical cream. 14 days later, he returned to the clinic reporting crusting of the rash, the biopsy results were positive for Herpes Zoster. The diagnosis of multidermatomal herpes Zoster was made and he was then treated with antivirals. Conclusions: Herpes Zoster can present with atypical manifestations. Multidermatomal HZ is a rare dermatological manifestation in the immunocompetent adult. It is characterised by a rash spread over two or more adjacent dermatomes. This case highlights the challenging diagnosis of this dermatological presentation.

Background: Cerebrospinal uid rhinorrhea is a potentially life threatening condition and it is a rare emergency presentation. Most cases has been related to head trauma. However, CSF leak post COVID swab has been rarely reported.Case presentation: We report a 10 year old Emirati 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 is a known case of 3MC syndrome and he underwent surgical repair for cleft lip and cleft palate. From the history and physical examination CSF rhinorrhea was highly suspected and nasal endoscopy con rmed the diagnosis of cribriform defect on the left side. The patient underwent surgical repair and his symptoms resolved after the surgery. Conclusion:We can conclude that COVID-19 nasopharyngeal swab has potential life threatening complications and one should consider the contraindications and the alternative methods available to detect COVID-19 to minimize the potential risks.