# Bilateral Three-Port Video-Assisted Thoracoscopic Thymectomy for Thymoma in Good’s Syndrome With a History of Bacteremia

## TL;DR

A patient with Good’s syndrome and a high infection risk successfully underwent a minimally invasive thymectomy with effective infection control.

## Contribution

This case demonstrates successful management of Good’s syndrome with a minimally invasive thymectomy and infection control strategy.

## Key findings

- Bilateral three-port thoracoscopic thymectomy was performed successfully in a high-risk patient.
- Perioperative infection control prevented postoperative complications.
- Good’s syndrome was effectively managed with a multidisciplinary approach.

## Abstract

A 62-year-old man presented with back pain, lower leg swelling, and fever and was referred to our hospital. Blood cultures identified Helicobacter fennelliae as the causative agent of bacteremia associated with pyogenic spondylitis and cellulitis. CT revealed a tumor in the upper anterior mediastinum, and blood tests showed low gamma globulin levels, raising the suspicion of Good’s syndrome. Infection control was prioritized, and the patient received antibiotics for four weeks. After blood cultures returned negative, preoperative gamma globulin was administered to mitigate infection risk, and a total thymectomy was planned. A bilateral three-port thoracoscopic total thymectomy was performed, and the patient was observed as an outpatient without any postoperative infection recurrence. We present a case of Good’s syndrome with a high infection risk, successfully managed with a minimally invasive bilateral three-port thoracoscopic total thymectomy and effective perioperative infection control.