Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10723-10727
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10723
Severe mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration: A case report
Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee, Song-I Lee
Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee, Song-I Lee, Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon 35015, South Korea
Author contributions: Koh JS and Lee SI, the patient’s attending physicians, reviewed the literature and contributed to manuscript drafting; Kim YJ reviewed the literature and contributed to manuscript drafting; Kang DH analyzed and interpreted the imaging findings; Koh JS, Kang DH, Lee JE, and Lee SI were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Song-I Lee, MD, Adjunct Professor, Department of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, South Korea.
Received: June 28, 2021
Peer-review started: June 28, 2021
First decision: July 26, 2021
Revised: July 29, 2021
Accepted: October 8, 2021
Article in press: October 8, 2021
Published online: December 6, 2021

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive diagnostic tool for mediastinal and hilum evaluation. However, infectious complications may occur after EBUS-TBNA. Among these, mediastinitis and pericarditis are rare.


A 67-year-old woman was referred to our hospital due to paratracheal lymph node enlargement on chest computed tomography (CT). EBUS-TBNA was performed on the lymph node lesions, and prophylactic oral antibiotics were administered. Seven days after EBUS-TBNA, the patient visited the emergency room with a high fever and chest pain. Laboratory test results revealed leukocytosis with a left shift and elevated C-reactive protein level (25.7 mg/dL). Chest CT revealed the formation of a mediastinal abscess in the right paratracheal lymph node and pericardial and bilateral pleural effusions. The patient received intravenous antibiotic treatment, cardiac drainage through pericardiocentesis, and surgical management. The patient recovered favorably and was discharged 31 d after the operation.


Mediastinitis and pericarditis after EBUS-TBNA are rare but should be considered even after the use of prophylactic antibiotics.

Keywords: Endoscopic ultrasound-guided fine needle aspiration, Complication, Mediastinitis, Pericarditis, Antibiotics, Case report

Core Tip: Acute mediastinitis and pericarditis are rare complications of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). This case presented with acute mediastinitis and pericarditis that developed despite prophylactic antibiotic use after EBUS-TBNA and improved after antibiotic and surgical management.