Simultaneous Chylothorax and Chylous Ascites Due to Tuberculosis

Kim, Kyeong Jin; Park, Dae Won; Choi, Won Suk

doi:10.3947/ic.2014.46.1.50

Cited by 19 publications

(21 citation statements)

References 18 publications

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“…A very high proportion also had disseminated TB at diagnosis (45.9%; 17/37), including miliary TB in 18.9% (7/37) [14, 18, 26, 32, 33, 35, 36]. Chylothorax developed in association with chylous ascites in 10.8% (4/37) of the cases [14, 26, 35, 38]. Chylothorax developed on the right side or bilaterally in the majority of cases (78.3%; 29/37).…”

Section: Resultsmentioning

confidence: 99%

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Tuberculosis-Associated Chylothorax: Case Report and Systematic Review of the Literature

Srinivas

Kancherla

Ramanathan³

2018

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Tuberculosis (TB) is a rare cause of chylothorax. We describe a case and the results of a systematic review of all reported cases of TB-chylothorax. We identified 37 cases of TB-chylothorax. The symptoms at presentation were constitutional (85.7%; 30/35), dyspnea (60.6%; 20/33), and cough (54.5%; 18/33). Chylothorax developed subsequent to the diagnosis of TB in 27.8% (10/36) of the patients, after a median of 6.75 weeks (IQR 4–9). Chylothorax developed during an immune reconstitution syndrome (IRS) in 16.7% (10/36) of the patients, including immunocompetent ones. TB was disseminated in 45.9% (17/37) of the patients at the diagnosis of chylothorax. Chylothorax developed in the absence of any mediastinal lymphadenopathy in 45.9% (17/37) of the patients; 13.5% (5/37) had isolated tubercular empyema alone. The diagnosis of TB was established microbiologically in 72.2% (26/36) and by biopsy alone in 27.8% (9/36) of the patients. Anti-TB treatment (ATT) was administered for a median of 7.57 months (IQR 6–9). Steroids were administered to 22.9% (8/35) of the patients, often for suspected IRS. Thoracic duct ligation and octreotide were required for only 17.1% (6/35) and 8.6% (3/35) of the patients, respectively. In all, 94.4% (34/36) of the patients had resolution of chylothorax and completed treatment successfully; only 5.6% (2/36) died. In conclusion, TB-chylothorax may develop without obvious mediastinal lymphadenopathy and be associated with tubercular empyema alone. TB-chylothorax can develop during treatment of TB due to IRS, even in immunocompetent patients. ATT and dietary manipulation are associated with good resolution and low mortality, and duct ligation is needed for only a small minority of patients.

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Section: Resultsmentioning

confidence: 99%

“…Tuberculous empyema was associated with chylothorax in 25% (9/36) of the cases, including the index case [10, 13, 21, 24, 27-29, 31, 35]. Pathologic biopsies of the involved organ alone established the diagnosis of TB in a further 27.8% (10/36) [6, 7, 16, 18-20, 31, 34, 37, 39].…”

Section: Resultsmentioning

confidence: 99%

Tuberculosis-Associated Chylothorax: Case Report and Systematic Review of the Literature

Srinivas

Kancherla

Ramanathan³

2018

Respiration

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“…A PubMed search using the MeSH terms 'tuberculosis' and 'chylothorax' identified seven case reports of children with TB-associated chylothorax (age of presentation ranging from 4 months to 17 years). [7][8][9][10][11][12] In three of the cases, TB was bacteriologically confirmed on gastric aspirate samples, in one case on bronchioalveolar lavage and in two cases on pleural fluid. All Fig.…”

Section: Discussionmentioning

confidence: 88%

Chylothorax in a child with rifampicin-resistant tuberculosis

McLaren

Lala

Dangor

et al. 2019

Afr J Thorac Crit Care Med

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Chylothorax is rare in children. Only a few cases of tuberculosis (TB)-associated chylothorax have been reported. We present a child on standard four-drug TB treatment who presented with wheezing and a chylothorax. Bronchoscopy showed caseating lymph nodes, and rifampicin-resistant TB was identified from the bronchoalveolar lavage specimen. There was marked clinical and radiological improvement 1 month after starting multidrug-resistant (MDR) TB treatment and steroids. The association of chylothorax and MDR-TB has not been described in children. MDR-TB should be considered in children who fail adherent, empirically started drug-susceptible TB treatment.Afr J Thoracic Crit Care Med 2019;25(3):123-126. https://doi.

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“…Merino and colleagues [7] reported a prevalence of pleural effusion of 22.1% of TB cases among children in their study population. Tuberculosis presenting with chylothorax however is rare [[23], [24], [25]], with chylothorax occasionally occurring with chylous ascites [26].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in children presenting with chylothorax - Report of two cases and review of the literature

Ayuk

Gray

Vanker

et al. 2019

Respiratory Medicine Case Reports

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One third of the world's population is estimated to be infected with Mycobacterium tuberculosis . Tuberculosis (TB) is endemic in many sub-Saharan African counties. The burden is further made worse by the HIV scourge. The number of children with TB and its attendant complications, is equally on the rise. TB can mimic many diseases ranging from infections to malignancies. Among pleuro-pulmonary TB complications, exudative effusion is more common while chylothorax is rare and thus easily missed especially if not the classical milky appearance. We present two children from a TB endemic region, with microbiologically-confirmed TB presenting with chylothoraces that were initially misdiagnosed as pleural empyema. Tuberculosis in children presenting as chylothorax is uncommon. These cases are instructive as they bring to the fore the importance of a full investigation of pleural effusions in children, to ensure a correct diagnosis and prompt effective management.

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Simultaneous Chylothorax and Chylous Ascites Due to Tuberculosis

Cited by 19 publications

References 18 publications

Tuberculosis-Associated Chylothorax: Case Report and Systematic Review of the Literature

Tuberculosis-Associated Chylothorax: Case Report and Systematic Review of the Literature

Chylothorax in a child with rifampicin-resistant tuberculosis

Tuberculosis in children presenting with chylothorax - Report of two cases and review of the literature

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