{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:20:32Z","timestamp":1767190832050,"version":"3.48.0"},"reference-count":7,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,1]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>This case report discusses a woman in her 30s presenting with an acute, rapidly progressive left anterior cervical swelling. While the neck swelling improved spontaneously, the patient subsequently developed large bilateral pleural effusions with respiratory failure requiring ventilatory support in the high dependency unit. Therapeutic thoracocentesis yielded chylous pleural fluid bilaterally. The respiratory failure subsequently improved and the patient was discharged home. This was an atypical presentation of chylothorax with no history of malignancy, atypical infection or apparent blunt trauma to the thoracic cage. The presence of bilateral chylothoraces suggested a multilevel thoracic duct injury. A significant tonic-clonic epileptic seizure, 6\u2009days prior, is hypothesised as the potential underlying cause, which has not previously been reported in the literature.<\/jats:p>","DOI":"10.1136\/bcr-2025-270661","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:35:36Z","timestamp":1767180936000},"page":"e270661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous bilateral chylothorax in a patient with epilepsy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3232-2864","authenticated-orcid":false,"given":"Chloe","family":"Lawrence","sequence":"first","affiliation":[{"name":"ENT, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Callum","family":"Riley","sequence":"additional","affiliation":[{"name":"Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shayan","family":"Lihony","sequence":"additional","affiliation":[{"name":"Emergency Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Holden","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Huntley","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"},{"name":"Applied Health Sciences, University of Birmingham, Birmingham, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Wharton","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama","family":"Abulaban","sequence":"additional","affiliation":[{"name":"Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2025123106152168000_18.12.e270661.1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.rmed.2019.08.014","article-title":"Clinical approach and review of causes of a chylothorax","volume":"157","author":"Riley","year":"2019","journal-title":"Respir Med"},{"key":"2025123106152168000_18.12.e270661.2","doi-asserted-by":"crossref","first-page":"108447","DOI":"10.1016\/j.ijscr.2023.108447","article-title":"Tension chylothorax following blunt neck injury: case report","volume":"108","author":"Abera","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"2025123106152168000_18.12.e270661.3","unstructured":"Rudrappa M , Paul M . Chylothorax. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2024. Available: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459206\/"},{"key":"2025123106152168000_18.12.e270661.4","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1002\/ccr3.3550","article-title":"Transient spontaneous chylothorax presented with neck pain and swelling in a patient with latent TB: Case report","volume":"9","author":"Almasri","year":"2021","journal-title":"Clin Case Rep"},{"key":"2025123106152168000_18.12.e270661.5","unstructured":"Anjum F , Allen BW , Syndrome TP . Lemierre syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2024. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK499846"},{"key":"2025123106152168000_18.12.e270661.6","doi-asserted-by":"crossref","first-page":"500A","DOI":"10.1016\/j.chest.2018.08.455","article-title":"Recurrent neck swelling leads to multiple spontaneous chylothoraces","volume":"154","author":"Macdonald","year":"2018","journal-title":"Chest"},{"key":"2025123106152168000_18.12.e270661.7","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.amjoto.2019.04.004","article-title":"Spontaneous cervical chyle fistula: A case report","volume":"40","author":"Appachi","year":"2019","journal-title":"Am J Otolaryngol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:15:51Z","timestamp":1767190551000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":7,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,31]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-270661"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270661","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}