Photoclinic Diagnosis: Chyliform Effusion Due to Inadvertent Insertion of Subclavian Catheter into Pleural Space

A38-year-old woman, a known case of myasthenia gravis, was admitted to our hospital’s intensive care unit (ICU) due to frequent exacerbations of her illness. She was receiving prednisolone, azathioprine, mestinone, cyclosporine, and intravenous immunoglobulin treatment. Thymectomy had been performed one year prior to this admission. The patient was successfully weaned from the ventilator after prolonged support and hyperalimentation via a subclavian catheter, but episodes of tachypnea and tachycardia persuaded physicians to provide her with intermittent airway support through a tracheostomy tube. On chest examination, there was a decrease in breath sounds with an increase in dullness, especially on the right side.