Incidence of Fever and Bacteremia following Transbronchial Needle Aspiration

doi:10.1378/chest.89.1.85

Chest

Volume 89, Issue 1, January 1986, Pages 85-87

https://doi.org/10.1378/chest.89.1.85 Get rights and content

Fiberoptic bronchoscopy and transbronchial needle aspiration were performed on 50 occasions in 47 afebrile patients. The aspirations were followed by endobronchial or transbronchial biopsies in 22 patients, as well as bronchial brushings and washings where appropriate. Blood for cultures was drawn at 5 and 30 minutes following needle aspiration, as well as at the time of any temperature above 38°C during the 24 hours following the procedure. In five (10 percent) of the 50 cases, there was temperature greater than 38°C(100.4°F) in the 24 hours following the bronchoscopy; in no patient were cultures of blood positive, whether done early after the procedure or at the time of fever. We conclude that transbronchial needle aspiration, a new procedure gaining widespread popularity in diagnostic thoracic medicine, is not associated with clinically detectable bacteremia. This procedure should not require antimicrobial prophylaxis in patients susceptible to endocarditis.

Section snippets

Materials and Methods

All patients undergoing transbronchial needle aspiration for the diagnosis or staging of carcinoma of the lung from April 1, 1984 to March 1, 1985 were included in this study. Informed consent was obtained, and the project was approved by the hospital's human use committee. The evaluations prior to entry included posteroanterior and lateral chest x-ray films, medical history, physical examination, and temperature. Patients excluded were those with fever, clinically evident

Results

Fifty transbronchial needle aspirations performed on 47 patients were entered into the study. The patients ranged in age from 34 to 80 years (mean, 60 years). The transbronchial needle aspiration was followed by transbronchial biopsy or endobronchial biopsy and brushings and washings in 22 of the 50 procedures. The total number of needle aspirations per patient ranged from four to 17 (mean, ten), and the number of times grossly bloody aspirations returned, indicating penetration into a major

Discussion

The transient nature of bacteremia following most procedures and manipulations of mucous membranes is of little consequence in most situations. In those patients with abnormalities of the cardiac valves and chambers or with arteriovenous fistulas or hyperalimentation lines, the risk for seeding these sites with bacteria and eventually causing infective endocarditis is substantial. There is no conclusive evidence of the efficacy of using systemic prophylactic antibiotics in susceptible patients

ACKNOWLEDGMENT

We thank Sgt Warren Parr, pulmonary technician, and Mrs. Lynette Emenzian for typing the manuscript.

REFERENCES (15)

WJ Watts et al.
Bacteremia following transbronchial fine needle aspiration
Chest
(1984)
SO Burman
Bronchoscopy and bacteremia
J Thorac Cardiovasc Surg
(1960)
KP Wang et al.
Transbronchial needle aspiration for diagnosis of lung cancer
Chest
(1981)
D Shure et al.
The role of transcarinal needle aspiration in the staging of bronchogenic carcinoma
Chest
(1984)
KP Wang et al.
Bronchoscopic needle aspiration biopsy of paratracheal tumors
Am Rev Respir Dis
(1978)
L Lemer et al.
Transbronchial fine needle aspiration
Thorax
(1982)
RC Kane et al.
Absence of bacteremia after fiberoptic bronchoscopy
Am Rev Respir Dis
(1975)

There are more references available in the full text version of this article.

Cited by (59)

Transient bacteremia induced by dental cleaning is not associated with infection of central venous catheters in patients with cancer
2018, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
The aim of this study was to determine the incidence of bacteremia resulting from dental cleaning and of subsequent established bloodstream infection (BSI) caused by oral microorganisms in patients with cancer with central venous catheters (CVCs).
Twenty-six patients with cancer with CVCs and absolute neutrophil count over 1000 cells/µL received dental cleaning without antibiotic prophylaxis. Periodontal status was assessed at baseline by using the Periodontal Screening and Recording (PSR) score. Blood cultures were drawn via the CVCs at baseline, 20 minutes into cleaning, and 30 minutes and 24 hours after cleaning. Medical records were monitored for 6 months.
Baseline blood culture results were negative in 25 patients. Nine of 25 patients (36%) had positive blood culture 20 minutes into cleaning, all associated with at least 1 microorganism typically found in the mouth. These 9 patients had significantly higher mean PSR score (3.22) compared with the other 16 (2.56; P = .035). These expected bacteremias did not persist, with blood culture results (0/25) at 30 minutes and 24 hours after cleaning showing no positivity (P = .001). There were no cases of CVC-related infection or BSI attributable to dental cleaning.
Bacteremia resulting from dental cleaning is transient and unlikely to cause CVC-related infection or BSI in patients with absolute neutrophil count greater than 1000 cells/µL.
Flexible Bronchoscopy
2013, Clinics in Chest Medicine
Citation Excerpt :
Kelly and coworkers98 found no significant bleeding in 15 patients with superior vena cava syndrome. Fever and bacteremia are also infrequent.99 Purulent pericarditis, hemomediastinum, and pneumomediastinum also are reported.100–102
Bronchoscopy: What Critical Care Nurses Need to Know
2010, Critical Care Nursing Clinics of North America
Citation Excerpt :
Serious risks, such as air leak or serious bleeding, occur less than 5% of the time.9 There are a variety of complications that can and do occur during a bronchoscopy.8–14 The more common complications and explanations are offered in Table 2.
Flexible Bronchoscopy and its Role in the Staging of Non-Small Cell Lung Cancer
2010, Clinics in Chest Medicine
Citation Excerpt :
No cases of mortality related to TBNA have been described. The rare complications reported are pneumothorax,72 pneumomediastinum,73 hemomediastinum,74 bacteremia,75 and pericarditis.76 None of these complications determined clinical major consequences.
Procalcitonin and proinflammatory cytokines in early diagnosis of bacterial infections after bronchoscopy
2019, Open Access Macedonian Journal of Medical Sciences
Major Complications Associated with Conventional Transbronchial Needle Aspiration
2018, Southern Medical Journal

View all citing articles on Scopus

: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

: Manuscript received April 1; revision accepted June 24.

View full text

Chest

Incidence of Fever and Bacteremia following Transbronchial Needle Aspiration

Section snippets

Materials and Methods

Results

Discussion

ACKNOWLEDGMENT

Chest

J Thorac Cardiovasc Surg

Chest

Chest

Bronchoscopic needle aspiration biopsy of paratracheal tumors

Am Rev Respir Dis

Transbronchial fine needle aspiration

Thorax

Absence of bacteremia after fiberoptic bronchoscopy

Am Rev Respir Dis