Da Vinci robot-assisted thoracoscopic duct ligation for bilateral chylothorax secondary to HIV-related Penicillium marneffei infection: A case report.

RATIONALE: Bilateral chylothorax is a rare clinical condition often associated with systemic diseases. This case report presents the successful treatment of bilateral chylothorax caused by human immunodeficiency virus (HIV)-related Penicillium marneffei infection using thoracic duct ligation via Da Vinci robot-assisted thoracoscopic surgery. PATIENT CONCERNS: A 33-year-old male with HIV and P marneffei infection presented with fever, cough, and progressive dyspnea. DIAGNOSES: Diagnostic imaging and pleural fluid analysis confirmed bilateral chylothorax. INTERVENTIONS: Thoracic duct ligation was performed using the Da Vinci robotic system. OUTCOMES: The procedure led to complete resolution of the chylothorax and significant improvement in respiratory symptoms. LESSONS: This case demonstrates the feasibility and safety of robot-assisted thoracoscopic surgery as a minimally invasive and effective approach for managing complex cases of bilateral chylothorax associated with HIV and P marneffei infection.