EBUS-TBNA-induced Purulent Pericarditis: A Rare Complication of a Common Procedure
  • Joana Alfaiate
    Serviço Medicina Interna - Centro Hospitalar do Médio Tejo, EPE, Abrantes, Portugal
  • Andreia Brito
    Serviço Medicina Interna - Centro Hospitalar do Médio Tejo, EPE, Abrantes, Portugal
  • Ana Matos
    Serviço Medicina Interna - Centro Hospitalar do Médio Tejo, EPE, Abrantes, Portugal

Keywords

Endobronchial ultrasound-guided transbronchial needle aspiration, infectious complications, pericarditis

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a diagnostic tool used to investigate mediastinal lesions. It has a good safety profile, but there are rare accounts of potentially deadly complications. The present article describes one such complication: pericardial empyema.
A 70-year-old man underwent EBUS-TBNA for the differential diagnosis of a pulmonary mass with multiple mediastinal adenopathies. Two weeks after the procedure he developed chest pain, shortness of breath and fever, with rapid progression to hypotension, tachycardia and low peripheral saturation. He was diagnosed with purulent pericarditis with cardiac tamponade. Pericardial drainage and antibiotic therapy were employed with successful recovery from obstructive disease and septic shock.

VIEW THE ENTIRE ARTICLE

References

  • Ortakoylu MG, Iliaz S, Bahadir A, Aslan A, Iliaz R, Ozgul MA, et al. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases. J Bras Pneumol 2015;41:410–414. doi: 10.1590/S1806-37132015000004493
  • Eapen GA, Shah AM, Lei X, Jimenez CA, Morice RC, Yarmus L, et al. Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration: results of the AQuIRE Registry. Chest 2013;143:1044–1053. doi: 10.1378/chest.12-0350
  • Asano F, Aoe M, Ohsaki Y, Okada Y, Sasada S, Sato S, et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res 2013;14:50. doi: 10.1186/1465-9921-14-50
  • Epstein SK, Winslow CJ, Brecher SM, Faling LJ. Polymicrobial bacterial pericarditis after transbronchial needle aspiration. Case report with an investigation on the risk of bacterial contamination during fiberoptic bronchoscopy. Am Rev Respir Dis 1992 Aug;146:523–525. doi: 10.1164/ajrccm/146.2.523.
  • Matsumoto T, Otsuka K, Imai Y, Tomii K. Bacterial pericarditis accompanied by sudden cardiac tamponade after transbronchial needle aspiration cytology. J Bronchol Interv Pulmonol 2016;23:155–159. doi: 10.1097/LBR.0000000000000190
  • Vallabhaneni S, Kichloo A, Rawan A, Aljadah M, Albosta M, Singh J, et al. Transbronchial needle aspiration cytology and purulent pericarditis. J Invest Med High Impact Case Rep 2020;8:2324709620951345. doi: 10.1177/2324709620951345
  • Haas AR. Infectious complications from full extension endobronchial ultrasound transbronchial needle aspiration. Eur Resp J 2009;33:935–938. doi: 10.1183/09031936.00025708
  • Lee HY, Kim J, Jo YS, Park YS. Bacterial pericarditis as a fatal complication after endobronchial ultrasound-guided transbronchial needle aspiration. Eur J Cardiothor Surg 2015;48:630–632. doi: 10.1093/ejcts/ezu477
  • Inoue T, Nishikawa T, Kunimasa K, Tamiya M, Kuhara H, Nishino K, et al. Infectious pericarditis caused by Gemella sanguinis induced by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): a case report. Resp Med Case Rep 2020;30:101057. doi: 10.1016/j.rmcr.2020.101057
  • Inaba M, Ushijima S, Hirata N, Saishoji S, Yoshinaga K. A case of mediastinal abscess and pericarditis complications after endobronchial ultrasound-guided transbronchial needle aspiration. J Jpn Soc Resp Endoscopy 2011;33:109–113. doi: 10.18907/jjsre.33.2_109
  • Fukunaga K, Kawashima S, Seto R, Nakagawa H, Yamaguchi M, Nakano Y. Mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration. Respirol Case Rep 2015;3:16–18. doi: 10.1002/rcr2.90
  • Matsuoka K, Ito A, Murata Y, Sakane T, Watanabe R, Imanishi N, et al. Severe mediastinitis and pericarditis after transbronchial needle aspiration. Ann Thorac Surg 2015;100:1881–1883. doi: 10.1016/j.athoracsur.2014.12.093
  • Sayan M, Arpag H. A rare complication of endobronchial ultrasound-guided transbronchial needle aspiration: pericardial empyema. Lung India 2019;36:154. doi: 10.4103/lungindia.lungindia_262_18X

    • Views: 293
    HTML downloads: 32
    PDF downloads: 168

    Published: 2023-03-18
    Issue: 2023: Vol 10 No 3 (view)

    How to cite:
    1.
    Alfaiate J, Brito A, Matos A. EBUS-TBNA-induced Purulent Pericarditis: A Rare Complication of a Common Procedure . EJCRIM 2023;10 doi:10.12890/2022_003738.