To the Editor.–Since the presence of an infection of the pleural space in congenital chylothorax is unusual, the case reported by Bensoussan et al in the October issue of the Archives (110:1243-1245, 1975) complicated by a chylous empyema deserves comment. Of the 34 cases we reviewed, only three patients had fever during their hospital course and none reported infected lymphatic fluid obtained from the pleural space.1,2 Though the authors stated that the "bilateral chylothorax reappeared," they did not report the lipid content of the fluid from which Staphylococcus aureus was cultured.
Prognosis appears to be related to the size of the effusion and not to the presence or absence of bilaterality, as the authors intimate in the discussion. In the cases we reviewed, none of the 15 patients with a so-called mild chylothorax treated by thoracentesis alone died, whereas three of seven patients with "severe" chylothorax treated by
BRODMAN RF. Chylothorax of the Newborn. Arch Surg. 1976;111(4):499. doi:10.1001/archsurg.1976.01360220195034