Chylous ascites is an uncommon finding of triglyceride-rich lymph in the peritoneal cavity. There are a variety of reported etiologies for chylous ascites; however, the reporting of chylous ascites among AIDS/HIV-positive patients is quite uncommon. This finding as a complication of immune reconstitution inflammatory syndrome is even more unusual. Here we report a case of an HIV-positive man with a history of colonic complex who developed chylous ascites in the setting of increasing CD4 counts and decreasing viral load, suggestive of immune reconstitution inflammatory syndrome.

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