A 13-Year-Old Boy With Dyspnea, Pleural Effusion, and Bone Lesions.

A 13-year-old boy was transferred to our institution for evaluation of a large, unexplained pleural effusion. He had a 1-month history of progressive dyspnea, accompanied by a 2-week history of fevers and a 2-kg weight loss, which was notable given his lean build. A chest CT scan performed at an outside hospital had revealed a large left-sided pleural effusion with associated low-density lesions in the sternum and vertebrae. A thoracic drainage tube had been placed, draining approximately 500 mL of turbid fluid daily. The patient's family reported no history of recent travel or exposure to pets.