Lymphoma Induced Chylothorax Complicated by Disseminated Histoplasmosis and Esophagopericardial Fistula

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.