[Congenital chylothorax: rapid and complete response to polyvidone iodine]

Idiopathic congenital chylothorax refers to abnormal accumulation of lymphatic fluid within the pleural space due the disruption of the thoracic duct or its lymphatic tributaries. It is a relatively rare disease and a cause of neonatal respiratory distress with major nutritional and immunological consequences. Therefore, it is critical to decrease pleural effusion promptly. Conservative treatment is always started as soon as the diagnosis is made, and refractory cases require chemical pleurodesis or surgery. However, the choice and timing of therapeutic escalation is not clear in the neonatal period and long waiting periods may have adverse consequences for the baby. We report a case of congenital idiopathic chylothorax who did not respond to conservative treatment after 18 days in whom one intrapleural injection of 5 mL of 4% concentrated Betadine stopped the pleural effusion promptly, effectively, and definitively, with no side effects observed, thus challenging such delayed administration.