Kurokawa Kana, Asao Tetsuhiko, Ko Ryo, Nagaoka Tetsutaro, Suzuki Kenji, Takahashi Kazuhisa
Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan.
Department of General Thoracic Surgery Juntendo University School of Medicine Tokyo Japan.
Respirol Case Rep. 2019 Apr 9;7(5):e00426. doi: 10.1002/rcr2.426. eCollection 2019 Jul.
Although endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been reported to be a minimally invasive and relatively safe procedure, mediastinitis is a serious complication related to the procedure. The median time of mediastinitis onset is approximately 12 days after EBUS-TBNA. Here we report two rare cases with mediastinitis onset 40 and 53 days after EBUS-TBNA. Surgical drainage was performed since systemic treatment with antibiotics was insufficient in both cases. Eikenella corrodens, which is a slow-growing microorganism, was identified as the causative pathogen in one case. To our knowledge, this is the first report of mediastinitis occurring over a month after EBUS-TBNA. Clinicians should consider the diagnosis of mediastinitis even if symptoms appear over a month after EBUS-TBNA.
尽管已有报道称支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）是一种微创且相对安全的操作，但纵隔炎是与该操作相关的严重并发症。纵隔炎发病的中位时间约为EBUS-TBNA术后12天。在此，我们报告两例罕见病例，纵隔炎分别在EBUS-TBNA术后40天和53天发病。由于两例病例使用抗生素进行全身治疗均不足，因此均进行了手术引流。在其中一例病例中，鉴定出缓慢生长的微生物——腐蚀埃肯菌为致病病原体。据我们所知，这是首篇关于EBUS-TBNA术后一个多月发生纵隔炎的报道。即使在EBUS-TBNA术后一个多月出现症状，临床医生也应考虑纵隔炎的诊断。
