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Case Reports: Rare disease
Mycobacterial disease causing chylous effusions in two patients living with uncontrolled HIV
  1. Katherine Elizabeth Dahill1,2,
  2. Jonathan Falconer2,
  3. Anton Pozniak2 and
  4. Margherita Bracchi2
  1. 1Critical care, University Hospital Aintree, Liverpool, UK
  2. 2HIV department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Jonathan Falconer; johnathanfalconer{at}gmail.com

Abstract

Chylous effusions are a rare complication of disseminated non-tuberculous mycobacterial (NTM) infection. This is a case couplet reporting on the treatment challenge of chylous effusions secondary to NTM infection in two individuals living with advanced HIV. Their treatment was complicated by associated immune reconstitution inflammatory syndrome. They both required intermittent paracentesis, steroid treatment and transitioning on to fat-free diets alongside NTM treatment. Only after months of this treatment regimen was successful resolution of the associated chylous effusions achieved. Chylous effusions in immunosuppressed patients living with NTM infection are rarely reported and difficult to manage. This report discusses treatment approaches and highlights the difficulties faced by the treating team.

  • Parenteral / enteral feeding
  • HIV / AIDS

https://doi.org/10.1136/bcr-2022-252000

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    Footnotes

    • Contributors The following authors were responsible for the drafting of the text, the sourcing and editing of clinical images, investigation results, and critical revision for important intellectual content:KED, JF, MB and AP. The following authors gave final approval of the manuscript: AP, MB, KED and JF.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.