Bilateral Chylothorax. An Unusual Presentation in the Course of Immune Reconstitution Inflammatory Syndrome, HIV Infection and Kaposi’s Sarcoma: A Case Report

Abstract

Immune reconstitution inflammatory syndrome (IRIS) is a term used to describe the paradoxical worsening of a pre-existing infection or the presentation of a previously undiagnosed condition in HIV-infected patients soon after commencement of antiretroviral therapy (ART). We report a case of a patient with HIV infection and Kaposi sarcoma, who developed bilateral chylothorax as a manifestation of IRIS, after the initiation of highly active antiretroviral therapy. Bilateral chylothorax is extremely rare and has been associated with significant morbidity and mortality. We present here the successful management with bilateral video-assisted thoracic surgery.

Chylous ascites in disseminated Kaposi sarcoma: an unusual manifestation as immune reconstitution inflammatory syndrome

“…KS-related chylothorax is described by a few authors as an unusual manifestation of KS,16–19 one of which also in context of IRIS 18. This could be explained due to metastatic KS in the thoracic duct and adjacent mediastinal structures, to in situ KS in the thoracic region20 or, probably, due to the negative intrathoracic pressure of the thorax, which drew ascitic fluid into the pleural space.…”