A Case of Post-Endobronchial Ultrasound Polymicrobial Pericarditis and Mediastinitis in Metastatic Renal Cell Carcinoma
Bibliographic record
Abstract
Introduction: Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a frequently used bronchoscopic method for sampling centrally located tumors and accessible mediastinal lymph nodes. It is widely employed for staging and obtaining tissue diagnosis in lung cancer, but it can also be used for other conditions with mediastinal lymph node metastases. Although the reported complication rate for EBUS-TBNA varies, it consistently remains low, including for severe infectious complications such as pericarditis and mediastinitis. Case Presentation: We present a unique case of polymicrobial pyogenic pericarditis, mediastinitis, and death in a patient who underwent EBUS-TBNA for the evaluation of solitary mediastinal lymphadenopathy in the background of previously resected renal cell carcinoma. There were no complications during her procedure and her mediastinal lymph node biopsy confirmed metastatic renal cell carcinoma. However, 23 days after her procedure, she presented to the emergency department with sepsis and cardiac tamponade. Pericardial fluid cultures and computed tomography imaging confirmed polymicrobial pyogenic pericarditis and mediastinitis. Conclusion: While complications from EBUS-TBNA are rare, clinicians need to be aware that pericarditis and mediastinitis are possible life-threatening complications in order to facilitate early recognition and interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".