# Successful Treatment of Congenital Chylothorax by Early Use of Prednisolone: A Case Report

## TL;DR

A newborn with congenital chylothorax was successfully treated with early prednisolone, leading to rapid recovery and discharge.

## Contribution

This case report demonstrates the potential effectiveness of early prednisolone administration in treating congenital chylothorax.

## Key findings

- The neonate was successfully treated with prednisolone from day one and extubated within four days.
- The patient was weaned off the ventilator at 10 days and discharged at 40 days of age.
- The case suggests early prednisolone may be a viable treatment strategy for congenital chylothorax.

## Abstract

Congenital chylothorax is the most common form of pleural effusion during the neonatal period; however, no treatment strategy exists. The pathogenesis and etiology of this disease are not fully understood; hence, several cases are difficult to treat. Some patients with chylothorax may not survive due to severe respiratory distress. Prednisolone (PSL) is sometimes used to treat congenital chylothorax but is rarely used in the early postnatal period. In this report, we describe a neonate with prenatal pleural effusion who was successfully treated with PSL from day one after requiring endotracheal intubation and ventilator management due to a postnatal diagnosis of chylothorax. The patient was extubated at four days of age, weaned from the ventilator at 10 days of age, and discharged home at 40 days of age after a total of 10 days of administration. Although the mechanism of action of PSL in chylothorax is unknown, and because it is a steroid, side effects such as gastrointestinal perforation and susceptibility to infection should be noted. The present case suggests the utility of early PSL administration for the treatment strategy of congenital chylothorax.