Mediastinal Abscess Following Endobronchial Ultrasound Transbronchial Needle Aspiration in a Patient With Sarcoidosis

Abstract

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a low rate of complications. It is used in the diagnosis of malignant and benign disease such as sarcoidosis. We report a case a 42-year-old man who had undergone EBUS-TBNA for diagnosis of mediastinal and hilar lymph node enlargement. Sarcoidosis was diagnosed on cytologic examination. Three weeks after the procedure, he developed a mediastinal abscess secondary to EBUS-TBNA. Sarcoidosis may be a risk factor for mediastinal infection complication. A local immune defect related to sarcoidosis may explain this risk. Our case underlines the importance of considering and recognizing this complication, and its possibility should be taken into account when undertaking the procedure for benign disease.

Endobronchial ultrasound‐guided transbronchial needle aspiration: Safe as it sounds

“…antibiotics . There are eight case reports of mediastinitis post‐EBUS‐TBNA including five cases developing mediastinal abscess . Two of these patients with mediastinal abscess suffered sepsis syndrome and shock .…”

“…Two of these patients with mediastinal abscess suffered sepsis syndrome and shock . All the five patients with mediastinal abscess were treated with antibiotics and surgical debridement . The causative organisms could be isolated in three patients, and were alpha streptococcus, diphtheroids and Klebsiella pneumoniae .…”

A late mediastinal complication of EBUS-TBNA: Case report and review of the literature

“…Although most often the mediastinal bleeding and the acute retrosternal thoracic pain it produces are self-limited and spontaneously resolving, there have been cases with life threatening complications such as hemopericardium leading to tamponade 12 . Further complication of hematoma with infection is possible, and life threatening mediastinitis or mediastinal abscess formation can occur after EBUS-TBNA [13][14][15] .…”

Surgical treatment for mediastinal abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review

“…The indication for the procedure was malignancy in 10 cases, particularly lymph node metastasis of lung cancer in 6 cases [4, 5, 8, 10, 11, 15]. In addition, the indications were sarcoidosis in 3 cases [12, 15] and nonspecific inflammatory changes in another 3 [7, 13, 14]. The implicated bacteria were of oropharyngeal origin, e.g., Klebsiella pneumonia [14], Actinomyces [15], hemolytic Streptococcus [9, 13], and Streptococcus intermedius [7].…”