Case reports

Chylothorax in a child with rifampicin-resistant tuberculosis

B J McLaren, S Lala, Z Dangor, C Verwey, X Song, E Mate, C Jardine, T Mabasa, V Mammen

Abstract


Chylothorax is rare in children. Only a few cases of tuberculosis (TB)-associated chylothorax have been reported. We present a child on standard four-drug TB treatment who presented with wheezing and a chylothorax. Bronchoscopy showed caseating lymph nodes, and rifampicin-resistant TB was identified from the bronchoalveolar lavage specimen. There was marked clinical and radiological improvement 1 month after starting multidrug-resistant (MDR) TB treatment and steroids. The association of chylothorax and MDR-TB has not been described in children. MDR-TB should be considered in children who fail adherent, empirically started drug-susceptible TB treatment.


Authors' affiliations

B J McLaren, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

S Lala, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

Z Dangor, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

C Verwey, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

X Song, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

E Mate, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

C Jardine, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

T Mabasa, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

V Mammen, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

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African Journal of Thoracic and Critical Care Medicine 2019;25(3):123-126. DOI:10.7196/SARJ.2019.v25i3.237

Article History

Date submitted: 2019-09-17
Date published: 2019-09-17

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