Infected Spontaneous Chylothorax

Natrajan, Sunil; Hadeli, Khaled; Quan, Stuart F.

doi:10.1016/s0732-8893(97)00179-x

Cited by 6 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should be borne in mind that chylous fluid is bacteriostatic, rich in lymphocytes and immunoglobulins, and secondary empyema is therefore unusual in such cases. (22) Despite the additional parenteral nutrition and fasting for 25 days (patient 3) and 30 days (patient 6), resulting in resolution in both cases. Of the 14 patients undergoing thoracic duct ligation, 5 (35.0%) died during the hospital stay.…”

Section: Resultsmentioning

confidence: 96%

Videotoracoscopia como uma opção no tratamento cirúrgico do quilotórax após cirurgia cardíaca pediátrica

et al. 2011

View full text Add to dashboard Cite

Objective: To evaluate the use of video-assisted thoracoscopy in the surgical treatment of chylothorax developed after the surgical correction of congenital heart disease in children. Methods: We reviewed the medical charts of 3,092 children who underwent surgery for congenital heart disease between February of 2002 and February of 2007 at the Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, in São Paulo, Brazil. Results: Of the 3,092 children, 64 (2.2%) presented with chylothorax as a postoperative complication. In 50 (78.1%) of those patients, the clinical management was successful, whereas it failed in 14 (21.9%), all of whom were then submitted to thoracic duct ligation by video-assisted thoracoscopy. The thoracic duct ligation was successful in 12 patients (86%) but failed in 2. In the postoperative period, additional clinical measures, such as a low-fat diet and parenteral nutrition, were required in order to resolve those 2 cases. There was no surgical morbidity or mortality. Of the 14 patients who underwent thoracic duct ligation, 5 (35%) died due to cardiac or infectious complications. Conclusions: Video-assisted thoracic duct ligation can be safely performed in patients with severe heart disease, and the outcomes are favorable.Keywords: Chylothorax; Heart defects, congenital; Thoracic duct. ResumoObjetivo: Avaliar o uso de videotoracoscopia no tratamento cirúrgico do quilotórax após cirurgia para correção de cardiopatias congênitas em crianças. Métodos: Revisamos os prontuários médicos de 3.092 crianças operadas para a correção de cardiopatias congênitas no Instituto do Coração/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP) entre fevereiro de 2002 e fevereiro de 2007. Resultados: Das 3.092 crianças, 64 (2,2%) apresentaram quilotórax como complicação pós-operatória. Em 50 (78,1%) dessas, o tratamento clínico foi bem-sucedido, enquanto esse falhou em 14 (21,9%), as quais foram submetidas à ligação do ducto torácico por videotoracoscopia. A ligação do ducto torácico obteve sucesso em 12 pacientes (86%) e falhou em 2 casos, os quais foram resolvidos com medidas clínicas adicionais, como dieta pobre em gorduras e nutrição parenteral. Não houve morbidade ou mortalidade relacionada à operação. Dos 14 pacientes, 5 (35%) faleceram em decorrência de complicações cardíacas ou infecciosas. Conclusões: A ligadura videoassistida do ducto torácico pode ser realizada com segurança em pacientes gravemente enfermos e com doença cardíaca grave, com resultados favoráveis.

show abstract

Section: Resultsmentioning

confidence: 96%

Videotoracoscopia como uma opção no tratamento cirúrgico do quilotórax após cirurgia cardíaca pediátrica

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Furthermore, although it has been indicated that the coexistence of empyema and chylothorax is rare because of the bacteriostatic nature of chyle, several reports have described cases of infected chylothorax [ 18 , 19 ]. In such cases, it was speculated that the loss of activated lymphocytes in chyle [ 20 ], hepatic hydrothorax [ 5 ], or concomitant immunosuppressive therapy [ 21 ] caused immunodeficiency. It has been reported that CC increases the risk of secondary immunodeficiency caused by lymphopenia or loss of immunoglobulins and various antibodies which may cause infectious chylothorax [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome

Oikawa

Ota

Iwasawa

et al. 2021

Case Reports in Pediatrics

View full text Add to dashboard Cite

Thoracic empyema usually occurs as a complication of bacterial pneumonia, but in rare cases, it is caused by hematogenous dissemination secondary to nonpulmonary diseases. Congenital chylothorax or chylothorax in children is associated with maldevelopment of the lymphatic system, nonimmune hydrops fetalis, several syndromes including Down syndrome, Noonan syndrome, or Turner syndrome, a complication of thoracic surgery, right heart failure with high central venous pressure, or tumors. There are very few reports of empyema associated with preexisting chylothorax. In the present study, we describe a rare case of thoracic empyema associated with congenital chylothorax and supravalvular pulmonary stenosis associated with clinically diagnosed Noonan syndrome. It is necessary to closely monitor patients with chylothorax because they are at risk of developing severe lung infections, such as pleural empyema or lung abscesses.

show abstract

“…It is also caused by non-traumatic causes and various malignancies and is occasionally spontaneous [2][3][4]. Chyle is considered bacteriostatic and infection in a chylothorax is thought not to occur [5,6]. Serratia marcescens harbors the gene AmpC which, if expressed, can cause the production of antibiotic destroying betalactamase enzymes making it multi-drug resistant.…”

Section: Introductionmentioning

confidence: 99%

Secondary infection of chylothorax with Serratia marcescens: a rare scenario post-cardiac surgery

Kumaran

Ramanan

Dharan

2019

Indian J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Infection of chylothorax is considered rare because chyle is inherently bacteriostatic. We report a case of an infected chylothorax occurring in a post-cardiac surgery patient caused by Serratia marcescens. Once considered a harmless saprophyte, Serratia marcescens is now recognized as an important opportunistic pathogen causing healthcare-associated infection with a propensity for antimicrobial resistance.

show abstract

Infected Spontaneous Chylothorax

Cited by 6 publications

References 4 publications

Videotoracoscopia como uma opção no tratamento cirúrgico do quilotórax após cirurgia cardíaca pediátrica

Videotoracoscopia como uma opção no tratamento cirúrgico do quilotórax após cirurgia cardíaca pediátrica

Thoracic Empyema Secondary to Congenital Chylothorax in a 14-Month-Old Boy with Noonan Syndrome

Secondary infection of chylothorax with Serratia marcescens: a rare scenario post-cardiac surgery

Contact Info

Product

Resources

About