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Rare cause of paradoxical worsening of pleural effusion in a patient with tuberculosis

A 33-year-old patient, Known case of chronic kidney disease on maintenance dialysis presented with complaints of low-grade fever and weight loss of 2 months duration. Computed tomography (CT) revealed bilateral mild pleural effusion with significant mediastinal and abdominal adenopathy. CT-guided fi... Full description

Journal Title: Lung India : Official Organ of Indian Chest Society 2017, Vol.34(2), p.167-169
Main Author: Duraikannan, Paramasivan
Other Authors: Saheer, S , Balamugesh, T , Christopher, Dj
Format: Electronic Article Electronic Article
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ID: ISSN: 0970-2113 ; E-ISSN: 0974-598X ; DOI: 10.4103/0970-2113.201315 ; PMCID: 5351360 ; PMID: 28360466
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recordid: pubmed_central5351360
title: Rare cause of paradoxical worsening of pleural effusion in a patient with tuberculosis
format: Article
creator:
  • Duraikannan, Paramasivan
  • Saheer, S
  • Balamugesh, T
  • Christopher, Dj
subjects:
  • Case Report
  • Chylothorax
  • Immune Reconstitution Inflammatory Syndrome
  • Paradoxical Reaction
  • Tuberculosis
ispartof: Lung India : Official Organ of Indian Chest Society, 2017, Vol.34(2), p.167-169
description: A 33-year-old patient, Known case of chronic kidney disease on maintenance dialysis presented with complaints of low-grade fever and weight loss of 2 months duration. Computed tomography (CT) revealed bilateral mild pleural effusion with significant mediastinal and abdominal adenopathy. CT-guided fine-needle aspiration cytology of abdominal lymph nodes and bone marrow culture was suggestive of tuberculosis. The patient was started on four drug anti-tubercular therapy, post 6 weeks of initiation he developed new onset fever and chest X-ray revealed moderate right pleural effusion. Diagnostic thoracocentesis was suggestive of chylothorax. To the best of our knowledge, this is the first case report of chylothorax due to the paradoxical reaction in the HIV-negative tuberculous patient.
language:
source:
identifier: ISSN: 0970-2113 ; E-ISSN: 0974-598X ; DOI: 10.4103/0970-2113.201315 ; PMCID: 5351360 ; PMID: 28360466
fulltext: fulltext
issn:
  • 0970-2113
  • 09702113
  • 0974-598X
  • 0974598X
url: Link


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titleRare cause of paradoxical worsening of pleural effusion in a patient with tuberculosis
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subjectCase Report ; Chylothorax ; Immune Reconstitution Inflammatory Syndrome ; Paradoxical Reaction ; Tuberculosis
descriptionA 33-year-old patient, Known case of chronic kidney disease on maintenance dialysis presented with complaints of low-grade fever and weight loss of 2 months duration. Computed tomography (CT) revealed bilateral mild pleural effusion with significant mediastinal and abdominal adenopathy. CT-guided fine-needle aspiration cytology of abdominal lymph nodes and bone marrow culture was suggestive of tuberculosis. The patient was started on four drug anti-tubercular therapy, post 6 weeks of initiation he developed new onset fever and chest X-ray revealed moderate right pleural effusion. Diagnostic thoracocentesis was suggestive of chylothorax. To the best of our knowledge, this is the first case report of chylothorax due to the paradoxical reaction in the HIV-negative tuberculous patient.
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abstractA 33-year-old patient, Known case of chronic kidney disease on maintenance dialysis presented with complaints of low-grade fever and weight loss of 2 months duration. Computed tomography (CT) revealed bilateral mild pleural effusion with significant mediastinal and abdominal adenopathy. CT-guided fine-needle aspiration cytology of abdominal lymph nodes and bone marrow culture was suggestive of tuberculosis. The patient was started on four drug anti-tubercular therapy, post 6 weeks of initiation he developed new onset fever and chest X-ray revealed moderate right pleural effusion. Diagnostic thoracocentesis was suggestive of chylothorax. To the best of our knowledge, this is the first case report of chylothorax due to the paradoxical reaction in the HIV-negative tuberculous patient.
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doi10.4103/0970-2113.201315
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pages167-169
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date2017-03-01