A rare case of acid-fast bacilli in chylothorax

Chylothorax is a rare cause of pleural effusion. Here we present a case of chylous pleural effusion in which acid-fast bacilli (AFB) was demonstrated (by AFB direct smear examination). The patient had been suffering from chronic pancreatitis for one year and had undergone pancreatoduodenostomy nine months back. He presented with abdominal pain and dyspnea of six months duration and his chest skiagram showed right-sided pleural effusion. Thoracocentasis showed milky white pleural fluid with triglyceride content of 678 mg/dl, diagnostic of chylothorax. The patient clinically improved and his pleural effusion also completely resolved with anti-tuberculosis treatment.