[Yellow nail syndrome]

We describe a 77 year old man with a prior history of recurrent airway infections, who presented with a history of cough, dyspnea and increased mucous production that had lasted several months. On chest X-ray a pleural effusion was observed. Subsequent thoracocentesis demonstrated an exudate with predominant eosinophils. An infectious cause was ruled out. The pleural effusion subsequently recurred and he was admitted for pleural biopsy, which revealed chronic pleuritis. On physical examination yellow nails on fingers and toes were noted. Subsequently, after exclusion of other diseases, a diagnosis of yellow nails syndrome was established. He was treated with corticosteroids, which were tapered over 6 months. One year later the eosinophilia had subsided, however the pleural effusion remained, although on a much smaller scale.