A Case of Bilateral Spontaneous Chylothorax with Respiratory Syncytial Virus Bronchiolitis

Authors

Mario Briceno-Medina, Division of Cardiology, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Michael Perez, Division of Cardiology, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Jie Zhang, Department of Pathology, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Ronak Naik, Division of Cardiology, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Samir Shah, Division of Critical Care Medicine, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
Dai Kimura, Division of Critical Care Medicine, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.

Abstract

A case of bilateral spontaneous chylothorax with respiratory syncytial virus (RSV) bronchiolitis has never been reported. We report the case of a 7-month-old boy born at 33 weeks gestation with a history of Down syndrome, atrial septal defect, pulmonary hypertension, and chronic lung disease, hospitalized due to RSV bronchiolitis who developed bilateral spontaneous chylothorax with exacerbation of pulmonary hypertension (PH). The patient died after 9 weeks of mechanical ventilation and treatment for PH. The autopsy showed acute infectious signs, a chronic interstitial lung disease with pulmonary hypertensive changes and subpleural cysts with no evidence of congenital lymphangiectasia. The cause of chylothorax in this child could be multifactorial. However, worsening pulmonary hypertension with RSV infection might have partially contributed to the development of chylothorax through elevated superior venous cava pressure. Thoracentesis should be considered for patients with Down syndrome and PH associated with congenital heart disease who develop persistent pleural effusion during RSV bronchiolitis to rule out chylothorax.

Publication Title

Case reports in pediatrics

Recommended Citation

Briceno-Medina, M., Perez, M., Zhang, J., Naik, R., Shah, S., & Kimura, D. (2019). A Case of Bilateral Spontaneous Chylothorax with Respiratory Syncytial Virus Bronchiolitis. Case reports in pediatrics, 2019, 2853632. https://doi.org/10.1155/2019/2853632