McLaren B, Song X, Mate E, Jardine C, Mabaso T, Mammen V, Lala S, Dangor Z, Verwey C
Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, and Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Afr J Thorac Crit Care Med. 2019 Sep 17;25(3). doi: 10.7196/SARJ.2019.v25i3.237. eCollection 2019.
Chylothorax is rare in children. Only a few cases of tuberculosis (TB)-associated chylothorax have been reported. We present a child on standard four-drug TB treatment who presented with wheezing and a chylothorax. Bronchoscopy showed caseating lymph nodes, and rifampicin-resistant TB was identified from the bronchoalveolar lavage specimen. There was marked clinical and radiological improvement 1 month after starting multidrug-resistant (MDR) TB treatment and steroids. The association of chylothorax and MDR-TB has not been described in children. MDR-TB should be considered in children who fail adherent, empirically started drug-susceptible TB treatment.
乳糜胸在儿童中较为罕见。仅有少数结核（TB）相关乳糜胸的病例报道。我们报告一名正在接受标准四联抗结核治疗的儿童，该患儿出现喘息和乳糜胸。支气管镜检查显示干酪样淋巴结，经支气管肺泡灌洗标本鉴定为耐利福平结核病。在开始耐多药（MDR）结核病治疗和使用类固醇药物1个月后，临床和影像学有显著改善。儿童乳糜胸与耐多药结核病的关联此前尚未见报道。对于依从性良好但经验性起始的药物敏感结核病治疗失败的儿童应考虑耐多药结核病。
