Introduction:
Chylopericardium is a pericardial effusion comprised of chyle carried by
the thoracic duct from the intestinal tract to the bloodstream.
Macroscopically, it appears milky white and opaque given its high
triglyceride content. Its etiology is subdivided into primary
(idiopathic) or secondary to trauma, recent thoracic or cardiac surgery,
or due to congenital abnormalities such as lymphangiomatosis.
Furthermore, pericardial analysis showing a high triglyceride level
greater than 500 mg/dL, a cholesterol/triglyceride ratio less than 1,
lymphocyte predominance, and negative culture confirms its diagnosis and
allows for its differentiation with cholesterol pericarditis or purulent
pericardial effusion. To our knowledge, a superimposed bacterial
infection of a chylopericardium has not been described in the
literature; although it seems to adequately respond to similar
management to purulent effusions, associated progression to chronic
pericarditis and rate of recurrence are yet to be elucidated.