Liu Bo, Aleksoniene Kristina, Patel Sapna R, McKillion Patrick C, Wang Michael S
Department of Medicine Corewell Health Southwest Saint Joseph Michigan USA.
Osteopathic Medical Specialties Michigan State University College of Osteopathic Medicine East Lansing Michigan USA.
Clin Case Rep. 2025 Sep 11;13(9):e70886. doi: 10.1002/ccr3.70886. eCollection 2025 Sep.
This case report highlights the need to consider both infection and malignancy in the differential of a chylothorax, particularly in an immunosuppressed patient. The case demonstrates the challenges in treating a chylothorax, both in terms of appropriate drainage and the necessity to maintain a low-fat diet. The case also presented challenges in treating histoplasmosis, both in terms of renal effects of amphotericin B and the effect of a low-fat diet on an oral antifungal agent. Although infection may be controlled with appropriate antifungal agents, the underlying hematologic malignancy must be controlled in order to successfully treat the patient.
本病例报告强调，在鉴别乳糜胸时需要同时考虑感染和恶性肿瘤，尤其是在免疫抑制患者中。该病例展示了治疗乳糜胸所面临的挑战，包括适当引流方面以及维持低脂饮食的必要性。该病例在治疗组织胞浆菌病方面也面临挑战，涉及两性霉素B对肾脏的影响以及低脂饮食对口服抗真菌药物的影响。尽管使用适当的抗真菌药物可能控制感染，但必须控制潜在的血液系统恶性肿瘤才能成功治疗患者。
