Chylous ascites and chylothorax due to constrictive pericarditis in a patient infected with HIV: a case report

Abstract

Introduction: Chylothorax and chylous ascites are uncommon and usually associated with trauma or neoplasms. To the best of our knowledge, constrictive pericarditis leading to chylothorax and chylous ascites in a person infected with HIV has never previously been described.

Case presentation: A 39-year-old Thai man was referred to our institute with progressive dyspnea, edema and abdominal distension. His medical history included HIV infection and pulmonary tuberculosis that was complicated by tuberculous pericarditis and cardiac tamponade. Upon further investigation, we found constrictive pericarditis, chylothorax and chylous ascites. A pericardiectomy was performed which resulted in gradual resolution of the ascites and chylous effusion.

Conclusions: Although constrictive pericarditis is an exceptionally rare cause of chylothorax and chylous ascites, it should nonetheless be considered in the differential diagnosis as a potentially reversible cause.

Figure 1

Radiograph of the chest. Posterior anterior view (A) showing left-sided pleural effusion. Lateral view (B) showing pericardial calcification (arrows).

Figure 2

Bottles containing milky fluid drained from left pleural cavity.

Figure 3

Computed tomography (CT; axial view) of the chest showing left-sided pleural effusion and a calcified pericardium (arrows).