Lady windermere syndrome variant: Atypical presentation in young female patient

Abstract

Non tuberculous lung infections with Mycobacterium are rare in this part of the continent. Lady Windermere syndrome (LWS) refers to the appearance of bronchiectasis, centrilobular nodules leading to the lung scarring in elderly population. This results in volume loss and the right middle lobe and lingual lobes are the mostly affected. The lung changes are the result of pulmonary Mycobaterium avium complex (MAC).We present a 24-years old young female who presented with the history of cough with off and on haemoptysis with breathlessness. Plain chest radiograph had shown some scar in the right mid zone. High resolution computerized tomography (HRCT) confirmed the findings of underlying bronchiectasis and collapse of right middle lobe. This was further confirmed by culture of bronchalveolar lavage fluid for MAC. The patient was put on combination with clathyromycin; rifampin and ethambitol for two years with regular follow up. The patient had shown remarkable improvement for the last one year.