Interventional Chest Diagnostic Procedures NetWork

The Food and Drug Administration (FDA) has contacted us regarding the regulatory status of the STERIS System 1 Processor (SS1) and actions that you should take if you have this medical device in your facility.

A 31-year-old African-American man reported to the ED with a 3-week history of productive cough, fever, chills, and pleuritic chest pain. He reported multiple episodes of pneumonia and bronchitis over the last several years. He also had been treated for asthma over the same time period.

The patient is a 35-year-old Caucasian woman reporting shortness of breath, wheezing, and cough during the last 4 years. She had been diagnosed with asthma and treated with albuterol with poor response. Her symptoms were exacerbated with exercise and during sleep.

A 36-year-old woman had advanced HIV/AIDS with a CD4+ count of 12, history of thymoma status postresection in 2001, history of DVT upper extremity secondary to PICC line recurrent in nature, history of fevers, cellulitis, and left upper lobe opacities. She was transferred from an outside hospital for further workup. She states that she has had persistent fevers, low-grade in nature over 2 months; was diagnosed with presumptive cytomegalovirus pneumonia; began a regimen of IV ganciclovir; and also began a regimen of highly active antiretroviral therapy (HAART) while being treated for Pneumocyctis carinii pneumonia (PCP). Her HAART regimen included tenofovir, efavirenz, and emtricitabine. She was initially admitted to an outside hospital 2 weeks prior for fever of unknown origin. A chest CT scan showed peribronchovascular consolidation with mediastinal and hilar lymphadenopathy. She was subsequently started on a regimen of micafungin, IV ganciclovir, vancomycin, and imipenem. She underwent bronchoscopy (Fig 1 and 2). Washings, transbronchial needle aspiration, and endobronchial biopsies were done.

Flexible bronchoscopy (FB) is one of the most common and useful procedures performed by chest clinicians, with > 500,000 procedures performed annually in the United States.1