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Case Reports
. 2023 May-Jun;40(3):271-274.
doi: 10.4103/lungindia.lungindia_494_22.

Scourge of tuberculosis: A rare case of simultaneous chylothorax and chylous ascites

Parth B Gada  1 , Rupali R Sachdev  2 , Waqar A Ansari  1 , Akash A Jadhav  2
Affiliations
Case Reports

Scourge of tuberculosis: A rare case of simultaneous chylothorax and chylous ascites

Parth B Gada et al. Lung India. 2023 May-Jun.

Abstract

Tuberculosis (TB) is a rare cause of chylothorax and chylous ascites. This is a case of simultaneous TB-chylothorax and chylous ascites in a 20-year-old patient who had been diagnosed with disseminated Multi-Drug Resistant (MDR) Tuberculosis two years ago. Abdominal distention with horseshoe-shaped dullness was found on examination. Abdominal ultrasound revealed gross ascites and bilateral gross pleural effusion. Pleural fluid analysis was positive for chylomicrons and revealed elevated Protein, Albumin, ADA, and Triglyceride. GeneXpert was negative and no growth was seen on culture. Lymphoscintigraphy showed a normal ascent of radio tracer along bilateral lower limb. Lymphangiogram and thoracic ductogram showed multiple dilated lymphatic ducts in the bilateral internal iliac region with obstruction of lymphatic flow in the iliac group of nodes. Low-fat diet was given. No interventional radiological approach or surgical correction could be done for the patient. He died after one and half years with progressive swelling and emaciation.

Keywords: Chylothorax; chylous ascites; lymphedema; lymphocele; tuberculosis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Lymphoscintigraphy showing normal ascent of radio tracer along bilateral lower limb
Figure 2
Figure 2
(a) Canulation of thoracic duct (solid arrow), (b) Thoracic ductogram (dotted arrow) multiple dilated lymphatic ducts in the bilateral internal iliac region with obstruction of lymphatic flow in the iliac group of nodes
Figure 3
Figure 3
(a) Coronal section of the venous phase of CT scan of Thorax and Abdomen showing bilateral pleural effusion (red arrows), ascites (green arrows) and hyperintense bilateral internal iliac and inguinal group of lymph nodes. (b) 3D reconstruction of CT scan of Thorax and Abdomen showing hyperintense bilateral internal iliac and inguinal group of lymph nodes (yellow arrows)
See this image and copyright information in PMC

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