A Serious Mediastinum Abscess Induced by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA): A Case Report and Review of the Literature

Hiroshi Ishimoto; Kazuhiro Yatera; Keigo Uchimura; Keishi Oda; Masaru Takenaka; Toshinori Kawanami; Fumihiro Tanaka; Hiroshi Mukae

doi:10.2169/internalmedicine.54.4465

CASE REPORTS

A Serious Mediastinum Abscess Induced by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA): A Case Report and Review of the Literature

Hiroshi Ishimoto, Kazuhiro Yatera, Keigo Uchimura, Keishi Oda, Masaru Takenaka, Toshinori Kawanami, Fumihiro Tanaka, Hiroshi Mukae

Author information

Hiroshi Ishimoto
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Kazuhiro Yatera
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Keigo Uchimura
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Keishi Oda
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Masaru Takenaka
Second Department of Surgery, University of Occupational and Environmental Health, Japan
Toshinori Kawanami
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
Fumihiro Tanaka
Second Department of Surgery, University of Occupational and Environmental Health, Japan
Hiroshi Mukae
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan

Keywords: endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinal lymphatic abscess, Streptococcus intermedius

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 20 Pages 2647-2650

DOI https://doi.org/10.2169/internalmedicine.54.4465

Details

Abstract

A 75-year-old man with interstitial pneumonia and enlarged mediastinal lymph nodes underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). He developed a high-grade fever seven days after EBUS-TBNA was performed; laboratory and radiologic findings showed intense inflammatory reactions, with swelling of the mediastinal lymph nodes on chest computed tomography. Mediastinal lymph node abscess was diagnosed, and it worsened in spite of systemic antibacterial treatment. Surgical treatment using a median sternotomy was performed, and the cultivation of surgically obtained mediastinal lymph node abscess fluid revealed Streptococcus intermedius. Combined treatment with antibiotics and surgical treatment was effective, leading to remission.

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