Milky urine with lipiduria and proteinuria on urinalysis should raise concern for chyluria. Chyluria can be caused by lymphatic filariasis, trauma, lymphatic malformations, or lymphatic obstructions due to malignancy or infection. In this patient’s case, lymphangiography identified a lymphatic-urinary fistula. Management of nonparasitic chyluria is generally conservative and involves a low-fat diet, though invasive interventions may be required if the clinical course remains murky.
Comment
Milky urine with lipiduria and proteinuria on urinalysis should raise concern for chyluria. Chyluria can be caused by lymphatic filariasis, trauma, lymphatic malformations, or lymphatic obstructions due to malignancy or infection. In this patient’s case, lymphangiography identified a lymphatic-urinary fistula. Management of nonparasitic chyluria is generally conservative and involves a low-fat diet, though invasive interventions may be required if the clinical course remains murky.