Bacterial pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a valuable diagnostic and staging tool for lung cancer and is generally considered a safe procedure with very low complication rates. Bacterial pericarditis is a rare but serious complication following EBUS-TBNA. Here we describe a case of bacterial pericarditis that developed after an EBUS-TBNA procedure. Case summary: A 61-year-old woman underwent EBUS-TBNA to investigate a tumor in her right lung. Two weeks after the procedure she presented to the emergency department due to dizziness, nausea and chest pain. Her condition rapidly deteriorated, leading to hypotension and cardiogenic shock. She was diagnosed with bacterial pericarditis resulting in cardiac tamponade. Emergency pericardial drainage was performed and treatment with antibiotics was started along with adjunctive corticosteroids. Although she initially responded well to treatment, she later developed constrictive pericarditis, which caused a slight reduction in cardiac output. She also responded well to treatment with Osimertinib for non-small-cell lung cancer. Conclusion: Bacterial pericarditis following EBUS-TBNA is a rare but severe complication. It has been associated with certain risk factors, particularly sampling necrotic lesions near the pericardium.

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