Tuberculous Chylous Ascites in a HIV Infected Adolescent: Challenges of Management in a Low Resource Country
Kingsley Asinobi
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Imo State, Nigeria.
Emeka Nwolisa *
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Imo State, Nigeria.
Udochikwuka Ikejiaku
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Imo State, Nigeria.
Joseph Ezeogu
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Imo State, Nigeria.
Kelechi Odinaka
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Imo State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Tuberculous chylous ascites is a challenging manifestation of tuberculosis which involves the accumulation of chyle, a milky fluid containing lymph and dietary fats, within the peritoneal cavity. It is an uncommon condition even in sub-Saharan Africa where the burden of tuberculosis (TB) is very high. While tuberculosis primarily affects the lungs, it can also target other organs, leading to various extrapulmonary manifestations like chylous ascites. Tuberculous chylous ascites is a result of the spread of Mycobacterium tuberculosis to the lymphatic system within the abdominal cavity. The infection triggers inflammation and obstruction of the lymphatic vessels, leading to the leakage of chyle into the peritoneal cavity.
When tuberculous chylous ascites occurs in a child with HIV/TB co-infection, it poses great challenges in management.
We present a case of a HIV/TB co-infected Nigerian adolescent with tuberculous chylous ascites.
Keywords: Chylous, ascites, tuberculosis, HIV