Purulent Pericarditis Following Endobronchial Biopsy of Lymph Node (4R)

Background: Purulent pericarditis is a rare but life-threatening complication of endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of intrathoracic lesions. Case Summary: A 65-year-old man with hypertension and hearing loss presented with an aggressive case of purulent pericarditis l...

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Bibliographic Details
Main Authors: Vijay Gupta, MD, MSc, Marie-Eve Mathieu, MD, Shaun A. Hanycz, MD, Bryan Stringer, MD, Luiz F. Ybarra, MD, PhD, MBA
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:JACC: Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666084925006473
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Summary:Background: Purulent pericarditis is a rare but life-threatening complication of endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of intrathoracic lesions. Case Summary: A 65-year-old man with hypertension and hearing loss presented with an aggressive case of purulent pericarditis leading to cardiac tamponade post-EBUS-FNA of a station 4R lymph node. Transthoracic echocardiogram demonstrated fibrinous stranding and tamponade physiology. Pericardiocentesis drained over 500 mL of purulent fluid positive for Streptococcus mitis. The patient was successfully managed with a prolonged course of culture-guided intravenous antibiotics. Discussion: To our knowledge, this is the first reported case of S. mitis purulent pericarditis post-EBUS-FNA. Take-home message: This case highlights the differential diagnosis of chest pain in patients undergoing EBUS-FNA and the utility of transthoracic echocardiography in the diagnosis of effusion-constrictive pericarditis.
ISSN:2666-0849