Inoue Takako, Nishikawa Tatsuya, Kunimasa Kei, Tamiya Motohiro, Kuhara Hanako, Nishino Kazumi, Fujiwara Mamoru, Fujita Masashi, Imamura Fumio, Kumagai Toru
Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
Department of Onco-Cardiology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
Respir Med Case Rep. 2020 Apr 13;30:101057. doi: 10.1016/j.rmcr.2020.101057. eCollection 2020.
A 69-year-old man had experienced right chest pain for several months. Chest computed tomography (CT) showed a right upper lobe lung tumor and swelling of multiple mediastinal and right hilar lymph node. Three punctures to 4R lymph nodes and two punctures to 11i lymph nodes were performed, using endobronchial ultrasonography. Thirty days after punctures, he was admitted with appetite loss and general fatigue. Chest CT supposed the evidence of mediastinitis and pericarditis. Despite the antibiotics, cardiac tamponade developed on the third hospital day. Pericardial fenestration and pericardial drainage were performed. Gram-positive cocci were identified and was eventually identified as the microbial identification system. Like the former reports, the necessity of surgical procedure for late onset of mediastinitis and pericarditis. caused by EBUS-TBNA was suggested.
一名69岁男性数月来一直感到右胸痛。胸部计算机断层扫描（CT）显示右上叶肺部肿瘤以及多个纵隔和右肺门淋巴结肿大。使用支气管内超声对4R淋巴结进行了3次穿刺，对11i淋巴结进行了2次穿刺。穿刺30天后，他因食欲减退和全身乏力入院。胸部CT显示有纵隔炎和心包炎的迹象。尽管使用了抗生素，但在住院第三天仍出现了心脏压塞。进行了心包开窗引流术。鉴定出革兰氏阳性球菌，最终通过微生物鉴定系统得以确认。与之前的报告一样，提示了对于由超声支气管镜引导针吸活检术（EBUS-TBNA）引起的迟发性纵隔炎和心包炎进行外科手术的必要性。
