Chylothorax in a child with rifampicin-resistant tuberculosis

Area of Science:

• Pediatrics
• Infectious Diseases
• Pulmonology

Background:

• Chylothorax is an uncommon condition in pediatric patients.
• Tuberculosis-associated chylothorax is rarely reported in children.
• Standard TB treatment regimens may not be effective in all pediatric cases.

Observation:

• A child presented with wheezing and chylothorax while undergoing standard four-drug tuberculosis treatment.
• Bronchoscopy revealed caseating lymph nodes.
• Rifampicin-resistant tuberculosis was detected in the bronchoalveolar lavage sample.

Findings:

• The child showed significant clinical and radiological improvement after initiating multidrug-resistant tuberculosis (MDR-TB) treatment and corticosteroids.
• This case highlights a previously undescribed association between chylothorax and MDR-TB in a pediatric patient.

Implications:

• MDR-TB should be suspected in pediatric patients with chylothorax who do not respond to empirical, adherent, drug-susceptible TB therapy.
• This finding expands the known clinical spectrum of MDR-TB in children.
• Prompt diagnosis and appropriate MDR-TB treatment are essential for favorable outcomes.