Infectious complications from full extension endobronchial ultrasound transbronchial needle aspiration

Abstract

The development of a convex probe endobronchial ultrasound (CP-EBUS) videobronchoscope to allow real-time transbronchial needle aspiration (TBNA) has been a significant advance in minimally invasive lung cancer staging and diagnosis. Several recent studies have demonstrated CP-EBUS-TBNA to have recovery rivalling that of the current gold standard, cervical mediastinoscopy. These same studies have indicated that the safety of this procedure has no reported complications.The present case study presents two infectious complications from full extension endobronchial ultrasound transbronchial needle aspiration and discusses possible aetiologies of these infections, as well as implications for future application of this technology.

Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study

“…The infection at the puncture site develops with crosscontamination of floral bacteria of the oral cavity and nasopharynx. 5,9,12 S. constellatus growing on blood culture of one of our cases is also within the floral bacteria of oral cavity and nasopharynx. In our study, EBUS-TBNA was performed on mediastinal cystic lesions in 2 (40%) of the 5 cases with infectious complications, and there were a total of 10 cases with cystic lesions.…”

“…No systemic bacteremia could be shown in this case, similarly to those in the study of Haas. 9 Hata et al 21 reported 2 cases of tuberculosis after EBUS-TBNA. One of them was complicated with the development of intrabronchial polypoid lesions at the puncture sites nearly 2 months after the EBUS-TBNA procedure at hilar and subcarinal lymph nodes.…”

“…For pericarditis occurring in one subject, he commented that full-needle extension must have allowed the needle tip to enter the pericardial space and caused pericardial contamination because the needle tip can be difficult to visualize in all planes when fully extended. 9 Our case with pericarditis had a 22.5-mm cystic paratracheal lesion. No systemic bacteremia could be shown in this case, similarly to those in the study of Haas.…”

“…[5][6][7][8][9]12,14 The incidences of complications may vary depending on several factors. First, follow-up of patients to detect possible complications is not often a routine procedure, and lack of documentation is also an important factor, especially for minor complications.…”

An Unusual Complication of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): the Needle Breakage

“…Haas reported two infectious complications from EBUS-TBNA. 6) One was a pericardial effusion that was positive for Actinomyces odontolyticus and Streptococcus mutans and the second was a lung abscess. Both complications were treated adequately with antibiotics.…”