Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3651-3657
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3651
Diagnosis based on electromagnetic navigational bronchoscopy-guided biopsied peripheral lung lesions in a 10-year-old girl: A case report
Fan-Zheng Meng, Qiong-Hua Chen, Man Gao, Li'e Zeng, Jie-Ru Lin, Jing-Yang Zheng
Fan-Zheng Meng, Man Gao, Department of Pediatrics, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Qiong-Hua Chen, Department of Respiratory Medicine, The Third Clinical Medical College, Fujian Medical University, Quanzhou Women's and Children's Hospital, Quanzhou 362000, Fujian Province, China
Li'e Zeng, Jie-Ru Lin, Department of Respiratory Medicine, Quanzhou Women's and Children's Hospital, Quanzhou 362000, Fujian Province, China
Jing-Yang Zheng, Department of Respiratory Medicine, Quanzhou Women's and Children's Hospital, The Third Clinical Medical College, Fujian Medical University, Quanzhou 362000, Fujian Province, China
Author contributions: Meng FZ and Chen QH were the first authors of this manuscript; Meng FZ and Zheng JY performed the operation; Chen QH, Zeng L and Lin JR collected clinical data and data interpretation; Meng FZ, Gao M, and Zheng JY helped revise the manuscript; Chen QH drafted the manuscript; all authors have read and approved the final manuscript.
Supported by The Natural Science Foundation of Jilin Province, No. 20200201475JC.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jing-Yang Zheng, MD, Professor, Department of Respiratory Medicine, Quanzhou Women's and Children's Hospital, The Third Clinical Medical College, Fujian Medical University, No. 700 Fengze Street, Fengze District, Quanzhou 362000, Fujian Province, China.
Received: February 21, 2023
Peer-review started: February 21, 2023
First decision: April 10, 2023
Revised: April 13, 2023
Accepted: April 19, 2023
Article in press: April 19, 2023
Published online: May 26, 2023
Processing time: 91 Days and 23.1 Hours

Electromagnetic navigational bronchoscopy (ENB) is an emerging diagnostic tool that enables practitioners to biopsy peripheral lung tissues that were previously only accessible under computed tomography (CT) guidance. However, few studies have investigated ENB use in children. Here, we report a case of a 10-year-old girl with peripheral lung lesions who complained of a 7-d persistent fever. She was diagnosed with Streptococcus parasanguinis infection based on findings obtained using ENB-guided transbronchial lung biopsy (TBLB).


A 10-year-old girl presented with constitutional symptoms of cough and fever of 7 days’ duration. Chest CT scans detected peripheral lung lesions and no endobronchial lesions. TBLB performed under the guidance of an ENB Lungpro navigation system was safe, well-tolerated, and effective for biopsying peripheral lung lesions. Examination of biopsied samples indicated the patient had a pulmonary Streptococcus parasanguinis infection, which was treated with antibiotics instead of more invasive treatment interventions. The patient’s symptoms resolved after she received a 3-wk course of oral linezolid. Comparisons of pre-treatment and post-treatment CT scans revealed absorption of some lung lesions within 7 mo of hospital discharge.


ENB-guided TBLB biopsying of peripheral lung lesions in this child is a safe, well-tolerated, and effective alternative to conventional interventions.

Keywords: Electromagnetic navigational bronchoscopy, Lungpro, Transbronchial lung biopsy, Child, Diagnosis, Case report

Core Tip: Electromagnetic navigational bronchoscopy-guided transbronchial lung biopsy is used to diagnose and treat pulmonary disorders in adults worldwide, but very few were reported in children. Moreover, diagnosing patients with peripheral lung lesions is still challenging, due to difficulties related to existing biopsy procedures. Here we present a case study conducted in China that demonstrated that electromagnetic navigational bronchoscopy-guided transbronchial lung biopsy is safe and effective when used to diagnose pediatric patients afflicted with peripheral pulmonary lesion-inducing disorders. Ultimately, clinicians adopting this procedure will be able to diagnose pulmonary disease cases without subjecting patients to invasive and risky surgical interventions.