title: Mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review.
abstract: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique that allows lung cancer nodal staging and biopsy of parabronchial and paratracheal tissue. Its simplicity, high diagnostic yield, ability to diagnose both benign and malignant conditions, and exceedingly low complication rate has resulted in rapid widespread adoption by surgeons and physicians. EBUS-TBNA-related complications, however, do occur and need to be considered when assessing the risk-benefit profile of performing the procedure, and if the patient represents with unexpected symptoms after the procedure. We describe a 64-year-old woman who presented with a mediastinal abscess 5 days after EBUS-TBNA. This case demonstrates the importance of considering EBUS-TBNA-related complications to guide relevant imaging decisions and antibiotic choices. We review the published literature regarding infective complications of EBUS-TBNA and propose possible pathophysiologies. These complications are likely to increase in frequency as the technique is more widely adopted.
authors.affiliation: *University of Queensland Thoracic Research Centre & Department of Thoracic Medicine, The Prince Charles Hospital, Chermside †Department of Thoracic Medicine, Nambour Hospital, Nambour, Qld, Australia.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Leong
authors.forename: Henry M
authors.initials: HM
authors.lastname: Marshall
authors.forename: Michael
authors.initials: M
authors.lastname: Bint
authors.forename: Ian A
authors.initials: IA
authors.lastname: Yang
authors.forename: Rayleen V
authors.initials: RV
authors.lastname: Bowman
authors.forename: Kwun M
authors.initials: KM
authors.lastname: Fong
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D000230:Adenocarcinoma / Q000601:surgery; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001999:Bronchoscopy / Q000009:adverse effects* / Q000379:methods; D016292:Procedural Sedation; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011859:Radiography
chemical_list: D000890:Anti-Infective Agents