Mycobacterial chylous ascites: report of three cases and systematic review

Mallick, Bipadabhanjan; Mandavdhare, Harshal; Aggarwal, Sourabh; Singh, Harjeet; Dutta, Usha; Sharma, Vishal

doi:10.1177/2049936118772754

Cited by 8 publications

(11 citation statements)

References 23 publications

(55 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mycobacterial‐related ascites has only been reported in humans, and is an uncommon occurrence associated with Mycobacterium tuberculosis and Mycobacterium avium‐intracellulare infections. In these cases, the abdominal effusion was chylous, and related to lymph node enlargement, constrictive pericarditis, and remote scrofuloderma 24 . The abdominal fluid in our case was classified as a low‐protein transudate.…”

Section: Discussionmentioning

confidence: 64%

Disseminated Mycobacterium avium subsp. hominissuis infection and ascites in an FIV‐positive cat

Paharsingh

Suepaul

Gyan³

et al. 2020

Veterinary Clinical Pathol

View full text Add to dashboard Cite

A 3-year-old, castrated, male, domestic shorthair cat presented to the University of the West Indies Veterinary Teaching Hospital for ongoing anorexia, progressive weight loss, lethargy, and shedding of fur. The cat was a found as stray kitten and was kept as an unvaccinated indoor/ outdoor cat. There was a history of waxing and waning periods of illness, and these episodes occurred annually from 1 year of age. 1.2 | Clinical findings On physical examination, the cat had a thin body condition of 3/9 (7.9 lbs), with generalized muscle wasting and mild pyrexia (103.1°F). The cat was depressed, in lateral recumbency, had mildly icteric mucous membranes, and mild stomatitis. There was moderate abdominal distension and a palpable abdominal fluid wave. Neurologic examination revealed hind limb ataxia with normal spinal cord reflexes. No abnormalities were appreciated in the thoracic and pelvic limbs, and proprioception was difficult to ascertain due to a depressed mental state. Initial diagnostic tests included a CBC, serum biochemical analysis (sodium, potassium, chloride, urea, creatinine, glucose, alkaline phosphatase [ALP], alanine aminotransferase [ALT], and gamma-glutamyl transferase [GGT] levels were assessed), thoracic and abdominal radiographs, abdominal ultrasound, and feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) testing. Urine could not be obtained for urinalysis as the bladder was empty. A few hours after hospitalization, the cat's condition worsened, and it developed a mild complex seizure. Diazepam (Roche Pakistan Ltd) was administered intravenously

show abstract

Section: Discussionmentioning

confidence: 64%

Disseminated Mycobacterium avium subsp. hominissuis infection and ascites in an FIV‐positive cat

Paharsingh

Suepaul

Gyan³

et al. 2020

Veterinary Clinical Pathol

View full text Add to dashboard Cite

show abstract

“…Various mechanisms may be responsible for the production of CA in patients with mycobacterial infection, including the obstruction of the lymphatic system due to enlarged lymph nodes or lymph nodal fibrosis ( 26 ). In the present case, CA developed after the improvement of lymph node swelling.…”

Section: Discussionmentioning

confidence: 99%

“…Chylous ascites (CA) is a possible complication in disseminated NTM ( 11 ) and is known to indicate a poor prognosis in HIV-positive disseminated NTM ( 12 ). However, CA has not been reported in patients with IFN-γAb-positive disseminated NTM.…”

Section: Introductionmentioning

confidence: 99%

Disseminated <i>Mycobacterium avium</i> Infection Complicated with Chylous Ascites in a Patient with Neutralizing Autoantibodies to Interferon-γ

et al. 2020

View full text Add to dashboard Cite

A 68-year-old man visited our hospital due to anorexia, weight loss and a fever. We diagnosed the patient with disseminated Mycobacterium avium complex (MAC) and confirmed the presence of interferon (IFN)-γ neutralizing autoantibodies (IFN-γAb). His lesions improved following antibiotic therapy, but chylous ascites (CA) developed seven months after treatment. CA was able to be controlled by subcutaneous octreotide and diet therapy. IFN-γAb is recognized as having a critical role in the pathogenesis of disseminated MAC disease, but its clinical features are not fully understood. CA may be a complication that develops during the treatment of disseminated MAC infection.

show abstract

“…The ascitic fluid can be used for biochemical tests, microbial cultures, and cytological examination. To the best of our knowledge, there are only 15 cases of MAI‐associated ascites reported in the peer‐reviewed literature, 1,2 and the cytomorphology of the peritoneal fluid in these cases has not been described in detail previously. Herein, we present the cytomorphological findings in a case of MAI‐associated ascites along with follow‐up histologic correlation.…”

Section: Introductionmentioning

confidence: 99%

“…The development of ascites due to Mycobacterium avium intracellulare (MAI) infection is extremely uncommon and is associated with a poor outcome. 1 Afflicted patients present with chylous ascites (milky appearing peritoneal fluid rich in triglycerides), similar to the peritoneal fluid seen in the setting of cirrhosis, malignancy, lymphatic obstruction, trauma, right heart failure, postradiation, pancreatitis, and infections (eg, tuberculosis and filariasis). The successful treatment of ascites depends upon an accurate diagnosis of the cause.…”

Section: Introductionmentioning

confidence: 99%

Cytomorphology of Mycobacterium avium intracellulare‐associated ascites

Satturwar

Pantanowitz

Xing

et al. 2020

Diagnostic Cytopathology

View full text Add to dashboard Cite

Ascites due to Mycobacterium avium intracellulare (MAI) infection is extremely rare and associated with a poor outcome. The cytomorphology of this condition has not been previously reported. We present a unique case of a 45-year-old woman with iatrogenic immunodeficiency who developed MAI-associated chylous ascites. The ascitic fluid cytology showed numerous lymphocytes and foamy histiocytes with abundant intracytoplasmic MAI organisms. The diagnosis was confirmed by tissue biopsy showing MAI mesenteritis. It is important to consider MAI-associated ascites in the differential diagnosis whenever ascitic fluid shows a predominant population of lymphocytes and macrophages, especially in immunocompromised patients.

show abstract

Mycobacterial chylous ascites: report of three cases and systematic review

Abstract: Chylous ascites due to mycobacterial infection is uncommon and associated with poor outcome. However, early diagnosis and nutritional management along with antimycobacterial therapy can improve outcome.

Cited by 8 publications

References 23 publications

Disseminated Mycobacterium avium subsp. hominissuis infection and ascites in an FIV‐positive cat

Disseminated Mycobacterium avium subsp. hominissuis infection and ascites in an FIV‐positive cat

Disseminated <i>Mycobacterium avium</i> Infection Complicated with Chylous Ascites in a Patient with Neutralizing Autoantibodies to Interferon-γ

Cytomorphology of Mycobacterium avium intracellulare‐associated ascites

Contact Info

Product

Resources

About