以非乳白色胸腔积液为首发表现的双侧结核性乳糜胸一例

A case report of bilateral tuberculous chylothorax with non-opalescent pleural effusion as the first presentation

一例45岁男性患者以“胸腔积液原因待查”收入院,胸腔穿刺引流后胸水由黄色脓性转变为乳白色后又转变为淡黄色,完善检查最终诊断为结核性乳糜胸。予抗结核、暂禁食、引流胸水及肠外营养支持等治疗后患者症状缓解,定期随访病情稳定。本病例警示临床医师对于结核性胸腔积液的鉴别诊断,需考虑同时存在乳糜胸,应进一步完善乳糜实验。

A 45-year-old male patient was admitted to the hospital with"the cause of pleural effusion(to be explored)",and the pleural effusion transformed from yellow purulent to milky white to light yellow after thoracentesis and drainage.The diagnosis of tuberculous chylothorax was finally considered following the examinations.The patient's symptoms relieved after treatments such as anti-tuberculosis,temporary fasting,drainage of pleural fluid,and parenteral nutritional support,and the disease was stable during regular follow-up.This case warns clinicians that the differential diagnosis of tuberculous pleural effusion should consider the simultaneous presence of chylothorax,and the further exploration of chylothorax test should be performed.