title: Purulent pericarditis after transbronchial biopsy.
abstract: A 28-year-old woman experienced hypotension and unresponsiveness. She had undergone bronchoscopy with needle biopsy 2 weeks before admission to evaluate hilar lymphadenopathy given suspicion of sarcoidosis. She had an elevated white blood cell count of 28,000/μL and a serum creatinine level of 4.0 mg/dL. Echocardiography showed a large pericardial effusion. Pericardiocentesis resulted in removal of 400 mL of yellow-green purulent material that grew Streptococcus milleri, Prevotella, Veillonella, and Peptostreptococcus species. Pericardiectomy and mediastinal washout were performed. Subsequently, her condition rapidly improved. She returned home after 26 days of admission. At 12-month follow-up, the patient had made a full recovery.
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ara
authors.initials: A
authors.lastname: Tachjian
authors.affiliation: Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA.
authors.forename: Keri M
authors.initials: KM
authors.lastname: Shafer
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Denkinger
authors.affiliation: Divisions of Interventional Cardiology and Vascular Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. Electronic address: dpinto@bidmc.harvard.edu.
authors.forename: Duane S
authors.initials: DS
authors.lastname: Pinto
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000009:adverse effects; D001999:Bronchoscopy / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D010490:Pericardial Effusion / Q000000981:diagnostic imaging; D020519:Pericardiocentesis; D010493:Pericarditis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis; D014463:Ultrasonography