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Successful use of doxycycline pleurodesis in non-immune hydrops fetalis secondary to congenital chylothorax
Journal article   Open access   Peer reviewed

Successful use of doxycycline pleurodesis in non-immune hydrops fetalis secondary to congenital chylothorax

Vilmaris Quinones Cardona, Michelle Clark, Margaret Gilfillan and Randy Stevens
Journal of pediatric surgery case reports, v 31, pp 60-63
Apr 2018
DOI: https://doi.org/10.1016/j.epsc.2017.12.013
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.epsc.2017.12.013View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Congenital chylothorax Doxycycline Non-immune hydrops Pleurodesis
Congenital chylothorax is a rare presentation of nonimmune hydrops fetalis (NIHF). We report a case of congenital chylothorax presenting as NIHF managed successfully with chemical pleurodesis. A term male infant presented at birth with anasarca and respiratory failure secondary to bilateral pleural effusions. The infant was initially managed with ventilation and tube thoracocentesis however re-accumulation of pleural fluid occurred when feeds were started. Pleural fluid analysis was consistent with congenital chylothorax. Pleural fluid re-accumulated despite conservative management with tube thoracocentesis, nutritional interventions and octreotide therapy but responded to chemical pleurodesis with doxycycline. To our knowledge, this is the first case of congenital chylothorax treated successfully with chemical pleurodesis utilizing doxycycline as the sclerosing agent. This case adds to the literature by providing support for doxycycline as an alternative agent for chemical pleurodesis in the management of congenital chylothorax. •Congenital chylothorax is a rare but potentially devastating neonatal condition.•Chemical pleurodesis is a treatment option for infants who fail conservative management.•Doxycycline pleurodesis has been effectively used for post-operative chylothoraces.•We successfully treated an infant with congenital chylothorax with doxycycline pleurodesis.•In this patient, doxycycline pleurodesis was found to be both safe and effective.

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