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.