EBUS-TBNA-INDUCED PURULENT PERICARDITIS: A RARE COMPLICATION OF A COMMON PROCEDURE

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.

Learning points: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has a good safety profile and is used to investigate peritracheal and peribronchial lesions, but severe complications have occurred so prophylactic measures should be implemented.Risk factors for infections due to EBUS-TBNA have not been properly established, but the presence of necrotic or cystic lesions and an elevated number of punctures during TBNA seem to be relevant.Although severe complications are rare, awareness of their existence may allow faster diagnosis and, consequently, a better prognosis.

Keywords: Endobronchial ultrasound-guided transbronchial needle aspiration; infectious complications; pericarditis.