Hemothorax in Dialysis Patients: The Importance of History and Differential Diagnoses

Long-term double-lumen central venous catheters are commonly used in patients undergoing hemodialysis but may be associated with rare and serious complications, such as injury to large veins, for example the jugular or subclavian vein. We report the case of a 42-year-old man with chronic kidney disease on hemodialysis and a history of treated extrapulmonary tuberculosis who was found to have a massive, asymptomatic, left-sided hemothorax. Differential diagnoses included tuberculosis recurrence, mesothelioma, and iatrogenic vascular injury related to a long-term catheter. This case underscores the importance of careful clinical history and differential diagnosis when evaluating pleural effusion in dialysis patients.