Abstract
BACKGROUND: Purulent pericarditis is a rare but life-threatening complication of endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of intrathoracic lesions. CASE SUMMARY: A 65-year-old man with hypertension and hearing loss presented with an aggressive case of purulent pericarditis leading to cardiac tamponade post-EBUS-FNA of a station 4R lymph node. Transthoracic echocardiogram demonstrated fibrinous stranding and tamponade physiology. Pericardiocentesis drained over 500 mL of purulent fluid positive for Streptococcus mitis. The patient was successfully managed with a prolonged course of culture-guided intravenous antibiotics. DISCUSSION: To our knowledge, this is the first reported case of S. mitis purulent pericarditis post-EBUS-FNA. TAKE-HOME MESSAGE: This case highlights the differential diagnosis of chest pain in patients undergoing EBUS-FNA and the utility of transthoracic echocardiography in the diagnosis of effusion-constrictive pericarditis.