Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

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.