Tuberculosis and persistent chylous ascites.
Pranjal Singh, Priyanka Naranje, Himanshu Narang et al.
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Case in brief
A late adolescent boy presented with fever, weight loss, and lymphadenopathy, leading to a diagnosis of extrapulmonary tuberculosis. His treatment was complicated by drug-induced liver injury and a tubercular psoas abscess, which required drainage. Following this, he developed persistent chylous ascites, which did not resolve despite prolonged antitubercular therapy. Advanced imaging revealed lymphatic obstruction, and intranodal lymphatic embolisation successfully resolved the ascites.
What made this case unusual
The case illustrates the rare complication of persistent chylous ascites due to lymphatic obstruction from healed tuberculous lymphadenitis, which is not commonly reported.
Diagnostic / clinical pearl
Clinicians should consider lymphatic complications in patients with extrapulmonary tuberculosis presenting with chylous ascites, especially when conventional treatments fail.
Why it matters
This case underscores the importance of advanced imaging techniques and interventional procedures in managing complex complications of tuberculosis.