Early Onset Chyliform Pleural Effusion-A Rare Case

Abstract

Chyliform pleural effusion is turbid or milky from high lipid content without cholesterol crystals. Chyliform pleural effusion is a rare presentation than chylous or pseudochylous pleural effusion. The mean duration of the effusion to turn chyliform is 5 years. A 20 year old male presented with dry cough, left side chest pain and dyspnea on exertion and gives history of bilateral pleural effusion for which he had taken empirical antituberculous treatment. Chest radiograph showed bilateral pleural effusion more on left side. Thoracentesis done on left side revealed milky white coloured fluid with elevated cholesterol levels and Mycobacterium tuberculosis was detected and was not resistant to Rifampicin in cartridge based nucleic acid amplification test[CBNAAT] for pleural fluid. Contrast enhanced CT chest showed healed fibrotic lesion in bilateral upper lobe with bilateral pleural effusion with thickened pleura on left side. Patient diagnosed as chyliform effusion and treated with Intercostal drainage and antituberculous treatment. Less than 200 cases of chyliform have been reported in the medical literature of which microbiologically confirmed tuberculous chyliform effusion is rarely reported. Chyliform effusion rarely develops within one year and Tuberculosis presenting as Chyliform pleural effusion is a rare phenomenon.

Keywords

• chyliform effusion
• cbnaat
• tuberculosis