Refractory chylothorax in HIV/AIDS-related disseminated mycobacterial infection

A 38-year-old man presented to a previous hospital in December 2011 with a high fever and acute abdominal pain. He was found to have abdominal lymphadenopathy and was diagnosed with HIV infection. His CD4 count was 25/mm3 and viral load was 490 000 copies/mL. He was transferred to our department for further investigations and treatment. Whole body CT revealed bulky, widespread lymphadenopathy, especially in the abdomen, but no ascites or pleural effusion (figure 1A, B). Stool, bone marrow and an abdominal lymph node specimen were positive for acid-fast bacillus stain. A diagnosis of disseminated non-tuberculous mycobacterial …