An unusual case of chylothorax complicating childhood tuberculosis

Çakır, Erkan; Gocmen, Basar; Uyan, Zeynep Seda; Öktem, Sedat; Kıyan, Gürsu; Karakoç, Fazilet; Ersu, Refika; Karadağ, Bülent; Dağlı, Tolga E.; Dağlı, Elif

doi:10.1002/ppul.20817

Cited by 11 publications

(7 citation statements)

References 28 publications

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“…Chylothorax increased or developed on ATT alone in 25% (9/36) of the cases, including in 16.7% (6/36) with IRS. However, thoracic duct ligation [12, 14, 20, 24, 36, 40] and octreotide [22, 26, 36] were required in only 17.1% (6/35) and 8.6% (3/35) of the cases, respectively. In all, 94.4% (34/36) of the cases had good resolution of chylothorax and completed treatment successfully; only 5.6% (2/36) died [18, 27].…”

Section: Resultsmentioning

confidence: 99%

“…Table) [6-40]; we excluded 8 reports containing 12 cases [41-49] because neither the full texts nor abstracts were available, as well as another 5 reports with 5 cases because there was no microbiologic or pathologic evidence of TB [50-54]. The cases where full information was not available were treated as “missing data.” There were 20 males and 16 females with a mean age of 39.27 ± 4.13 years; 13.9% (5/36) were children [15, 22, 23, 26]. The patients had had symptoms for a median of 1 month (range 0.1–24 months) prior to presentation to the hospital (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Constitutional symptoms in the form of fever, anorexia, and weight loss (85.7%; 30/35), dyspnea (60.6%; 20/33), cough (54.5%; 18/33), and chest pain (30.3%; 10/33) were the most common symptoms at presentation. Close contact with a source of pulmonary TB [22, 23, 30] or a prior history of TB [6, 12, 31] was reported by 8.3% (3/36) of the patients each.…”

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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Srinivas

Kancherla

Ramanathan³

2018

Respiration

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“…The most common cause of nontraumatic chylous effusion is a malignancy, such as lymphoma or metastatic carcinoma [3, 4]. Other causes of nontraumatic chylous effusion include idiopathic, congenital anomaly, protein-losing enteropathy and TB [7, 8]. One case of systemic lupus erythematosus [7] and one case of Henoch-Schönlein purpura [9] accompanied by chylothorax and chylous ascites at a same time have been reported.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Chylothorax and Chylous Ascites Due to Tuberculosis

2014

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Chylothorax or chylous ascites is rare manifestation of tuberculosis. We report a case of simultaneous chylothorax and chylous ascites due to tuberculosis. A 17-year-old girl was admitted with fever, abdominal distention and dyspnea. Chest and abdominal computed tomography revealed bilateral pleural effusion, multifocal nodular consolidation on both lung fields and copious ascites and multiple necrotic lymphadenopathy in the abdominal cavity. Mycobacterium tuberculosis was isolated from sputum and pleural fluid. The patient was treated with anti-tuberculosis medication. Pleural effusion and ascites improved with the medication.

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“…7,79,80 The presence of a nontraumatic chylothorax is an indication for a diligent search for a lymphoma. 1 Granulomatous infections such as tuberculosis, [81][82][83] histoplasmosis, 84 and sarcoidosis 85 can be associated with the development of chylothorax attributable to lymphadenopathy obstructing the thoracic duct. Other etiologies include staphylococcal discitis 86 and Henoch-Schönlein purpura.…”

Section: Causes Of Chylothoraxmentioning

confidence: 99%

Chylothorax in Infants and Children

2014

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Chylothorax, the accumulation of chyle in the pleural space, is a relatively rare cause of pleural effusion in children. It can cause significant respiratory morbidity, as well as lead to malnutrition and immunodeficiency. Thus, a chylothorax requires timely diagnosis and treatment. This review will first discuss the anatomy and physiology of the lymphatic system and discuss various causes that can lead to development of a chylothorax in infants and children. Then, methods of diagnosis and treatment will be reviewed. Finally, complications of chylothorax will be reviewed. Pediatrics 2014;133:722-733

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An unusual case of chylothorax complicating childhood tuberculosis

Cited by 11 publications

References 28 publications

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

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

Simultaneous Chylothorax and Chylous Ascites Due to Tuberculosis

Chylothorax in Infants and Children

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