Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea, pleuritic chest pain, and non-productive cough. History significant for recent thoracic surgery, trauma, or suspected malignancy. Symptoms exacerbated by high-fat intake. No fever or constitutional symptoms reported.
Clinical Examination Findings
Respiratory exam reveals decreased breath sounds, dullness to percussion, and decreased tactile fremitus over the affected hemithorax. Tracheal deviation may be present if effusion is massive. Vital signs stable, though tachycardia may be noted secondary to respiratory distress.
Treatment Protocol
Initiate low-fat, medium-chain triglyceride (MCT) diet to reduce chyle production. Consider total parenteral nutrition (TPN) if refractory. Therapeutic thoracentesis or chest tube drainage for symptomatic relief. Evaluate for surgical intervention (thoracic duct ligation) or pleurodesis if persistent.