3.2 Case 2: Generalized Lymphatic Anomaly
A 12-year-old male presented to the emergency room with fever,
tachycardia, hypotension, and difficulty breathing. Chest x-ray showed
large right-sided pleural effusion causing midline shift (Figure
2A) . Broad-spectrum antibiotics were started, and a chest tube was
urgently placed, which drained milky white pleural fluid. Pleural fluid
cultures grew Streptococcus pneumoniae . Chest CT demonstrated
multiple lytic lesions involving the ribs. Medical history revealed that
the patient had a “cyst” removed from his back when he was a toddler.