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Marty PK, Yetmar ZA, Zhang Z, Temesgen Z, Nelson DR. Mediastinal Infection After Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: An Uncommon Complication. J Bronchology Interv Pulmonol 2023; 30:307-310. [PMID: 36729086 DOI: 10.1097/lbr.0000000000000909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/16/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Paige K Marty
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic
| | - Zachary A Yetmar
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Zhenmei Zhang
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic
| | - Zelalem Temesgen
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN
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Serra Mitjà P, Gonçalves Dos Santos Carvalho F, Garcia Olivé I, Sanz Santos J, Jiménez López J, Núñez Ares A, Tomás López L, Centeno Clemente C, Tazi R, Castellà E, Abad Capa J, Rosell Gratacós A, Andreo Garcia F. Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study. Arch Bronconeumol 2023; 59:84-89. [PMID: 36446657 DOI: 10.1016/j.arbres.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/29/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022]
Abstract
The aim of our study was to describe the incidence of infectious complications of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and to analyze the potential risk factors in a prospective cohort of patients. METHODS We conducted a prospective multicenter study, with all consecutive patients referred for an EBUS-TBNA with patients at risk of developing an infectious complication (considering>10 nodal samplings, known immunosuppression, bronchial colonization and cavitated or necrotic lesions) and a second group without any risk factor. RESULTS Three hundred seventy patients were included: 245 with risk factors and 125 without risk factors (as the control group). Overall, 15 patients (4.05%) presented an acute infectious complication: fourteen in cases (5.7%) and 1 in controls (0.8%). Of these, 4 patients presented pneumonia, 1 mediastinitis, 4 obstructive pneumonitis and 6 mild complications (respiratory tract infection that resolved with antibiotic). Also 7 (1.9%) patients had self-limited fever. One-month follow-up showed 1 mediastinitis at sixteenth day post-EBUS, which required surgical treatment, and 3 pneumonias and 3 respiratory tract infections at nineteenth day (1.9%). All patients had a good evolution and there were no deaths related with infectious complication. We observed an increased risk of complication in patients with risk factors and in patients with necrosis (p=0.018). CONCLUSIONS The incidence of infectious complications in a subgroup of patients with risk factors was higher than in patients without risk factors. Nevertheless, it remains low, and no fatal complication occurred, which reinforces the idea that EBUS-TBNA is a safe technique for the assessment of the mediastinum. Necrotic lesions are a risk factor of post-EBUS infection, and their puncture should be avoided.
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Affiliation(s)
- Pere Serra Mitjà
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain.
| | | | - Ignasi Garcia Olivé
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain
| | | | | | | | | | - Carmen Centeno Clemente
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain
| | - Rachid Tazi
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain
| | - Eva Castellà
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jorge Abad Capa
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain; Universitat Autònoma de Barcelona, UAB, Spain
| | - Antoni Rosell Gratacós
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain; Universitat Autònoma de Barcelona, UAB, Spain
| | - Felipe Andreo Garcia
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Institut Investigació Germans Trias i Pujol, IGTP, Spain; Universitat Autònoma de Barcelona, UAB, Spain
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Stirpe E, Bardaro F, Köhl J. Unusual lymphadenopathy diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. Monaldi Arch Chest Dis 2022; 93. [PMID: 35608519 DOI: 10.4081/monaldi.2022.2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 01/21/2023] Open
Abstract
Oxidized cellulose, used as hemostatic in thoracic surgery, may cause in some cases foreign body reactions, and simulate other diseases. We report the case of a 39-year-old man operated on a middle lobe lobectomy for atypical carcinoid. The follow up chest-CT showed enlarged mediastinal lymph nodes, so endobronchial ultrasound-guided transbronchial needle aspiration was performed suspecting recurrence of the tumor. The cytology results showed amorphous fragments such as foreign body reaction secondary to Pahacel®, used as hemostatic during the surgery. A few days later, the patient was re-operated on suspicion of mediastinitis induced by the endoscopic procedure. The aim of this case is to consider the foreign body reaction to Pahacel®, in patients with postoperative thoracic lymphadenopathy. It is also important to remember that in these patients the endoscopic procedures allow the diagnosis but may cause mediastinitis.
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Affiliation(s)
| | | | - Johanna Köhl
- Department of Respiratory Diseases, Bolzano Hospital.
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Kang N, Shin SH, Yoo H, Jhun BW, Lee K, Um SW, Kim H, Jeong BH. Infectious complications of EBUS-TBNA: A nested case-control study using 10-year registry data. Lung Cancer 2021; 161:1-8. [PMID: 34481209 DOI: 10.1016/j.lungcan.2021.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/02/2021] [Accepted: 08/26/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become a standard procedure, but little is known about its infectious complications. The aim of this study is to evaluate the incidence and risk factors of infectious complications of EBUS-TBNA and its clinical course, including effects on anti-cancer treatment. METHODS This is a nested case-control study of patients who received EBUS-TBNA and were followed for at least 2 months at Samsung Medical Center from August 2009 to April 2019. Patients with clinical symptoms of infection and correlating chest images were defined as the infection group (n = 33). The controls were randomly selected from patients without infectious complication. Multivariate logistic regression with backward selection was used to identify the risk factors of infectious complications. RESULTS Of the 6826 patients, 33 (0.48%) infectious complications were identified, comprising pneumonia (n = 20) and mediastinal infections (n = 13). Target lesions with necrotic features on chest computed tomography (CT) scan (adjusted odds ratio [aOR], 3.08; 95% confidence interval [CI], 1.49-6.40; P = 0.002) and procedures that were performed via the esophagus (aOR, 3.19; 95% CI, 1.47-6.88; P = 0.003) were independently associated with infectious complications. Among patients ultimately diagnosed with cancer, the infection group tended to refuse anti-cancer treatment compared to controls (32/459, 7.0% vs. 5/30, 16.7%; P = 0.066). However, among the patients who received anti-cancer treatment, there was no delay in onset of treatment. CONCLUSIONS Infectious complications of EBUS-TBNA are rare; however, attention should be paid if the target lesion appears necrotic on chest CT or if the procedure is performed via the esophagus. Although it was not conclusive due to its rarity, patients with infectious complications tended not to receive anti-cancer treatment.
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Affiliation(s)
- Noeul Kang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun Hye Shin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hongseok Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyungjong Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang-Won Um
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Inoue T, Nishikawa T, Kunimasa K, Tamiya M, Kuhara H, Nishino K, Fujiwara M, Fujita M, Imamura F, Kumagai T. Infectious pericarditis caused by Gemella sanguinis induced by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA): A case report. Respir Med Case Rep 2020; 30:101057. [PMID: 32346508 PMCID: PMC7183228 DOI: 10.1016/j.rmcr.2020.101057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/09/2020] [Accepted: 04/11/2020] [Indexed: 12/20/2022] Open
Abstract
A 69-year-old man had experienced right chest pain for several months. Chest computed tomography (CT) showed a right upper lobe lung tumor and swelling of multiple mediastinal and right hilar lymph node. Three punctures to 4R lymph nodes and two punctures to 11i lymph nodes were performed, using endobronchial ultrasonography. Thirty days after punctures, he was admitted with appetite loss and general fatigue. Chest CT supposed the evidence of mediastinitis and pericarditis. Despite the antibiotics, cardiac tamponade developed on the third hospital day. Pericardial fenestration and pericardial drainage were performed. Gram-positive cocci were identified and Gemella sanguinis was eventually identified as the microbial identification system. Like the former reports, the necessity of surgical procedure for late onset of mediastinitis and pericarditis. caused by EBUS-TBNA was suggested.
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Affiliation(s)
- Takako Inoue
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Tatsuya Nishikawa
- Department of Onco-Cardiology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kei Kunimasa
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hanako Kuhara
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kazumi Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Mamoru Fujiwara
- Clinical laboratory department, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masashi Fujita
- Department of Onco-Cardiology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Fumio Imamura
- Department of Medical Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Toru Kumagai
- Department of Onco-Cardiology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
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Uchimura K, Yamasaki K, Hirano Y, Sakagami K, Kido T, Mukae H, Yatera K. The Successful Removal of a Broken Needle as an Unusual Complication of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA): A Case Report and Literature Review. J UOEH 2019; 41:35-40. [PMID: 30867398 DOI: 10.7888/juoeh.41.35] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is recommended for the diagnosis of mediastinal lymph nodes by the American College of Chest Physicians guidelines; however, the guidelines state that this procedure should only be performed by a trained bronchoscopist. Complications related to needle malfunction during the EBUS-TBNA procedure have recently been reported. We herein describe a rare case involving the successful management of a needle breakage that occurred as an unusual complication of EBUS-TBNA. An 81-year-old male patient with a medical history of myocardial infarction was introduced to our institution to undergo an evaluation for mediastinal and right hilar lymphadenopathy on chest computed tomography (CT). We performed EBUS-TBNA in a 14×10 mm subcarinal lymph node station using a 22 G aspiration needle (NA-201SX-4022, Vizishot®, Olympus, Japan) for diagnosing and staging of the patient's lung cancer. After the second aspiration, we noticed that the needle tip was broken and that it was stuck in the right main bronchus. We immediately removed the broken needle tip from the right main bronchus by flexible bronchoscopy using an ID 8.5 mm tracheal tube without cuff inflation. The length of the needle tip was 13 mm and it was considerably bent. The EBUS scope did not suffer any apparent damage. The patient did not have any other procedure-related complications. Needle breakage during EBUS-TBNA is rare; however, inhaling or swallowing of a broken needle tip has the potential to cause serious complications. Bronchoscopists should therefore be aware of the possibility of needle breakage, which is an important complication during EBUS-TBNA.
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Affiliation(s)
- Keigo Uchimura
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Yoko Hirano
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuki Sakagami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University School of Medicine
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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Shimada S, Furusawa H, Ishikawa T, Kamakura E, Suzuki T, Watanabe Y, Fujiwara T, Tominaga S, Komatsuzaki KM, Natsume I. Development of mediastinal adenitis six weeks after endobronchial ultrasound-guided transbronchial needle aspiration. Respir Med Case Rep 2018; 25:161-164. [PMID: 30175038 PMCID: PMC6115609 DOI: 10.1016/j.rmcr.2018.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 12/29/2022] Open
Abstract
A 60-year-old man visited our hospital for further examination of an abnormal chest radiograph. Computed tomography (CT) images revealed enlarged mediastinal lymph nodes and multiple pulmonary nodules. Further evaluation by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed and he was diagnosed with sarcoidosis. Six weeks after EBUS-TBNA, he presented to the emergency department with a high-grade fever. CT scan revealed an enlarged mediastinal lymph node. He was diagnosed with mediastinal adenitis and treated successfully with antibiotics. EBUS-TBNA is a highly accurate diagnostic tool, but clinicians should be aware of mediastinal infectious complication that could be asymptomatic for long period of time.
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Affiliation(s)
- Sho Shimada
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan.,Department of Integrated Pulmonology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Haruhiko Furusawa
- Department of Integrated Pulmonology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Toshihisa Ishikawa
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
| | - Eisaku Kamakura
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
| | - Takafumi Suzuki
- Department of Integrated Pulmonology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Yuta Watanabe
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
| | - Takasato Fujiwara
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
| | - Shinichiro Tominaga
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
| | - Keiko Mitaka Komatsuzaki
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
| | - Ichiro Natsume
- Department of Respiratory Internal Medicine, Yokosuka Kyosai Hospital, 1-16 Yonegahama dori, Yokosuka, Kanagawa, 238-8558, Japan
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Hameed S, Singh J, Tricia LB, Machado A, Ruggieri P, Mehta AC. Conglomerate mediastinal mass of a different etiology. Oxf Med Case Reports 2017; 2017:omx072. [PMID: 29308210 PMCID: PMC5751060 DOI: 10.1093/omcr/omx072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/08/2017] [Accepted: 09/16/2017] [Indexed: 11/12/2022] Open
Abstract
Streptococcus intermedius is a Gram-positive commensal of the oral cavity with tendency to cause brain and liver abscesses. Mediastinal involvement from S. intermedius is very rare. We present a case of 22-year-old male with newly detected mediastinal conglomerate nodal mass. On his way for bronchoscopy, he developed seizures and was found to have three brain lesions. The aspirate from brain biopsy grew S. intermedius whereas the aspirate from mediastinum showed only acute inflammation. Follow up imaging after antibiotic treatment showed interval resolution of brain abscesses and the mediastinal mass. We believe that the patient had aspiration pneumonia from S. intermedius which then metastasized to mediastinum and brain. Our aim is to make physicians aware of this unusual presentation of S. intermedius infection as a mediastinal mass. A strong effort should be made to isolate the organism from the involved body sites and fluid cavities to confirm the diagnosis.
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Affiliation(s)
| | | | - Lulette B Tricia
- Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA
| | - André Machado
- Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Paul Ruggieri
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Atul C Mehta
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
- Correspondence address. Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA. Tel: +1-216-444-2911; Fax: +1-216-445-8160; E-mail:
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Yokoyama Y, Nakagomi T, Shikata D, Higuchi R, Oyama T, Goto T. Surgical treatment for mediastinal abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review. World J Surg Oncol 2017; 15:130. [PMID: 28709438 PMCID: PMC5513248 DOI: 10.1186/s12957-017-1206-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/08/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful and less invasive procedure for the definitive diagnosis of mediastinal and hilar lymph nodes. However, infectious complications can occur after EBUS-TBNA, although they are extremely rare. CASE PRESENTATION A 66-year-old man with necrotic and swollen lower paratracheal lymph nodes underwent EBUS-TBNA. A mediastinal abscess developed 9 days post-procedure. Surgical drainage and debridement of the abscess were performed along with lymph node biopsy followed by daily washing of the thoracic cavity. Surgical treatment was effective, leading to remission of the abscess. Biopsy revealed that the tumor was squamous cell carcinoma with no radiologically detected cancer elsewhere in the body. Mediastinal lung cancer was thus confirmed. Subsequent chemoradiotherapy led to the remission of the tumor. CONCLUSIONS Mediastinitis after EBUS-TBNA is rare but should be considered, particularly if the target lymph nodes are necrotic. Mediastinitis can lead to serious and rapid deterioration of the patient's condition, for which surgical intervention is the treatment of choice.
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Affiliation(s)
- Yujiro Yokoyama
- Department of General Thoracic Surgery, Yamanashi Central Hospital, Yamanashi, 400-8506, Japan
| | - Takahiro Nakagomi
- Department of General Thoracic Surgery, Yamanashi Central Hospital, Yamanashi, 400-8506, Japan
| | - Daichi Shikata
- Department of General Thoracic Surgery, Yamanashi Central Hospital, Yamanashi, 400-8506, Japan
| | - Rumi Higuchi
- Department of General Thoracic Surgery, Yamanashi Central Hospital, Yamanashi, 400-8506, Japan
| | - Toshio Oyama
- Department of Pathology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Taichiro Goto
- Department of General Thoracic Surgery, Yamanashi Central Hospital, Yamanashi, 400-8506, Japan.
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Kim SY, Lee JW, Park YS, Lee CH, Lee SM, Yim JJ, Kim YW, Han SK, Yoo CG. Incidence of Fever Following Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration. Tuberc Respir Dis (Seoul) 2016; 80:45-51. [PMID: 28119746 PMCID: PMC5256340 DOI: 10.4046/trd.2017.80.1.45] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/12/2016] [Accepted: 10/04/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic method for mediastinal and hilar lymphadenopathy. This study aimed to investigate the incidence of fever following EBUS-TBNA. METHODS A total of 684 patients who underwent EBUS-TBNA from May 2010 to July 2012 at Seoul National University Hospital were retrospectively reviewed. The patients were evaluated for fever by a physician every 6-8 hours during the first 24 hours following EBUS-TBNA. Fever was defined as an increase in axillary body temperature over 37.8℃. RESULTS Fever after EBUS-TBNA developed in 110 of 552 patients (20%). The median onset time and duration of fever was 7 hours (range, 0.5-32 hours) after EBUS-TBNA and 7 hours (range, 1-52 hours), respectively, and the median peak body temperature was 38.3℃ (range, 37.8-39.9℃). In most patients, fever subsided within 24 hours; however, six cases (1.1%) developed fever lasting longer than 24 hours. Infectious complications developed in three cases (0.54%) (pneumonia, 2; mediastinal abscess, 1), and all three patients had diabetes mellitus. The number or location of sampled lymph nodes and necrosis of lymph node were not associated with fever after EBUS-TBNA. Multiple logistic regression analysis did not reveal any risk factors for developing fever after EBUS-TBNA. CONCLUSION Fever is relatively common after EBUS-TBNA, but is transient in most patients. However, clinicians should be aware of the possibility of infectious complications among patients with diabetes mellitus.
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Affiliation(s)
- Seo Yun Kim
- Division of Pulmonology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Jin Woo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Young Sik Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Min Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Young Whan Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Koo Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Gyu Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
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