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Ann Thorac Surg 2009;88:1012-1013. doi:10.1016/j.athoracsur.2009.01.053
© 2009 The Society of Thoracic Surgeons
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Felix G. Fernandez
Chadrick E. Denlinger
Daniel Kreisel
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Right arrow Mediastinum

Case Reports

Massive Bilateral Chylothoraces Complicating Mediastinal Granulomatous Disease

Felix G. Fernandez, MD, Chadrick E. Denlinger, MD, G. Alexander Patterson, MD, Daniel Kreisel, MD, PhD, Alexander S. Krupnick, MD*

Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri

Accepted for publication January 19, 2009.

* Address correspondence to Dr Krupnick, Barnes-Jewish Hospital South, Queeny Tower, One Barnes-Jewish Hospital Plaza, 3108, St. Louis, MO 63110 (Email: krupnicka{at}wudosis.wustl.edu).

Mediastinal granulomatous disease with resulting fibrosis is known to cause several serious complications, including pulmonary artery occlusion, bronchial stenosis, superior vena cava syndrome, and constrictive pericarditis. This process is typically the result of an excessive fibrogenic response to the antigen of the fungus Histoplasma capsulatum. We present a case of a 20-year-old man who had massive bilateral chylothoraxes develop as a complication of mediastinal granulomatous disease. Aggressive surgical therapy was necessary to treat this potentially life-threatening condition with an excellent result.






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