A Case of Purulent Lymphadenitis After Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) That Improved by Drainage with EBUS-TBNA

<p>Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has a low incidence of complications, but care must be practiced, as infectious complications carry the risk of becoming serious. We herein report a case of purulent lymphadenitis after EBUS-TBNA that improved by drainage with EBUS-TBNA. Case. A 33-year-old man was referred to our hospital because of abnormal chest shadows. Computed tomography (CT) showed bilateral hilar, mediastinal and abdominal lymphadenopathy and nodular shadow with cavity in right upper lung. Sarcoidosis was pathologically diagnosed by EBUS-TBNA via the #7 lymph node. Brain magnetic resonance imaging revealed brain lesions, and high-dose steroid therapy was started 11 days after bronchoscopy. The patient had a fever when he came to our department for a follow-up visit 39 days after bronchoscopy (day 1). We performed CT again, which showed swelling of the #7 lymph node with an internal low-density area, and increased white blood cells and C-reactive protein levels were also observed on blood tests. He was thus diagnosed with purulent lymphadenitis, and antibiotic treatment was started. Blood tests and a CT reexamination on day 5 showed no improvement, so purulent drainage was performed on day 6 using EBUS-TBNA. A purulent specimen was submitted for a bacteriological examination, and multiple anaerobic bacteria were detected. Continued antibiotic treatment improved his condition. Conclusion. Drainage of purulent lymphadenitis with EBUS-TBNA may lead to a favorable outcome.</p>