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Case Reports: Unusual association of diseases/symptoms
Lady Windermere syndrome with haemoptysis: suspected pulmonary aspergilloma and MAC pulmonary disease
  1. Natalia Nazarenko,
  2. Pawel Borkowski,
  3. Melissa Morales Berges and
  4. Dimitrios Varrias
  1. Medicine, Jacobi Medical Center, Bronx, New York, USA
  1. Correspondence to Dr Natalia Nazarenko; nmykhailiuk{at}gmail.com

Abstract

We present a case of a woman in her 70s, with a history of Mycobacterium avium complex (MAC) pulmonary disease, pectus excavatum, s-shaped thoracolumbar scoliosis, bronchiectasis of the right middle lobe, lingula of left upper lobe, and malnutrition with low body mass index of 14 kg/m2, who presented to the hospital due to worsening shortness of breath and small volume haemoptysis over 2 weeks. The patient was diagnosed with pulmonary MAC infection for the first time in 1999 without known history of pulmonary disease. Later on, it was complicated by massive haemoptysis requiring bronchial artery embolisation; however, she was unable to complete an oral antibiotic regimen due to gastrointestinal adverse reactions. Chest CT identified a newly found mass in the left upper lobe bulla, consistent with a radiological finding of aspergilloma. We present a rare symptoms constellation, described as ‘Lady Windermere syndrome’ and chronic untreated MAC infection progressing from reticulonodular changes to fibrocavitary lung disease and suspected aspergilloma formation.

  • infections
  • respiratory system
  • infectious diseases
  • pneumonia (infectious disease)
  • malnutrition

https://doi.org/10.1136/bcr-2023-256349

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    Footnotes

    • NN and PB contributed equally.

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—NN, PB, MMB and DV. The following authors gave final approval of the manuscript—NN, PB, MMB and DV.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.