TITLE:
Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine
AUTHORS:
F. M. R. Maoulainine, N. Elidrissi Slitine, L. Erguig
KEYWORDS:
Congenital Chylothorax, Polyvidone Iodine
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.6 No.1,
March
3,
2016
ABSTRACT: Introduction: Congenital chylothorax, defined by the presence of chyle in
the pleural cavity, is a rare congenital disorder of varying severity. The
objective of this study was to report a case of idiopathic congenital
chylothorax treated with povidone iodine effectively without side effects after
failure of conservative treatment by chest drainage. Case presentation: A term
female Newborn was admitted in the neonatal intensive care unit at 16 days of
life, for respiratory distress. The Clinical examination objectified a
Sliverman score of 3/10 with a pleural effusion syndrome. The chest radiography
confirmed the pleural effusion and the analysis of the pleural fluid after
aspiration confirmed the chylothorax, with a protein rate of 35 g/l,
Triglycerids 37 mg/L, and Leukocytes count was 1140/ml with 90% lymphocytes. A
chest drainage was performed on the seventh day but followed by the recurrence of the effusion. The use of 5 ml of 4%
povidone iodine in the pleural space as a chemical pleurodesis was
performed. The clinical and radiological evolution was favorable after 24 hours
without relapse or side effects such as allergic reaction or worsening of the
respiratory condition. Thoracic ultrasound was performed after 15 days, having
objectified minimal right side effusion measuring 5 mm maximum thickness. Conclusion:
Chemical pleurodesis by the polyvidone iodine in the chylothorax appears to be
affordable and effective, and needs to be more considerate in the conservative
treatment of congenital chylothorax.