TB Research

A case report of tuberculous chylothorax

Luis Alejandro Rodríguez-Hidalgo, Luis Alberto Concepción‐Urteaga, Jorge Luis Cornejo-Portella, Oscar Neri Alquízar-Horna, Daniel Anderson Aguilar-Villanueva, Marcio José Concepción‐Zavaleta, Diana Cecilia Ruiz-Caballero

Medwave · 2019-06

Abstract

Tuberculous chylothorax is a rare infectious disease that occurs when the thoracic duct is obstructed. Treatment is directed to the tuberculosis infection. A 55-year-old male, driver, born in Trujillo (Peru) is admitted to the emergency department with increasing dyspnea and a 5-day dry cough. The physical examination revealed vocal fremitus, dullness to percussion, and a vesicular murmur that was decreased on the lower 2/3 of the left hemithorax. The X-ray and the thoracic ultrasound revealed significant left pleural effusion. The thoracocentesis drained fluid identified as chylothorax. Subsequently, a thoracic tube was placed, with a decrease in pleural fluid volume and later normalization of the cytochemical changes. Diagnostic video bronchoscopy was performed with a bronchoalveolar aspirate, revealing acid-fast bacilli. The patient received antituberculosis treatment with a favorable outcome. Tuberculous chylothorax is an important cause of chylothorax to be considered in endemic areas of tuberculosis. Proper treatment of the infection leads to resolution of the disease.

MeSH terms

  • Medicine
  • Chylothorax
  • Pleural effusion
  • Tuberculosis
  • Surgery
  • Thoracic duct