Bacterial pericardial effusion secondary to endobronchial ultrasound guided needle aspiration

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely used procedure in lung cancer diagnosis with few serious complications. We present a rare case of pericardial effusion secondary to EBUS-TBNA. An 80-year-old male with interstitial lung disease, developed a pericardial effusion composed exclusively of oropharyngeal flora following EBUS-TBNA. Bacterial pericardial effusion following EBUS-TBNA has only been reported in the literature seven previous times. The majority of these cases reported a biopsy of the 4R lymph node. This case highlights the potential risk of pericardial effusion when sampling lymph nodes, particularly station 4R, in patients with a high-riding superior pericardial recess.