Chylothorax Causing Neonatal Respiratory Distress: A Case Report

Although pleural effusions in the neonate are extremely rare, with few reported cases, the most frequent cause is chylothorax. A female infant presented with respiratory distress caused by the presence of pleural effusions from bilateral chylothorax. She was mechanically ventilated and numerous aspirations of the pleural effusions were made, revealing a yellow, serous-type fluid. After she began feedings of breast milk, the aspirated effusions revealed a white, milky-type fluid. The constituents of the aspirant and serial chest x-ray films confirmed the diagnosis of chylothorax. The infant's feedings were changed to Progestimil, which contains medium-chain triglycerides, and the chylothorax did not reappear. The infant was subsequently discharged from the hospital on room air in no apparent respiratory distress.