PDF(Pubmed)
Abstract：
Mycobacterium avium complex (MAC) is often observed in immunocompromised individuals. However, when pulmonary MAC infection occurs in immunocompetent individuals, particularly elderly females, characteristically involving the middle lobe and lingula lobe of the lung, it is known as Lady Windermere syndrome (LWS). A 64-year-old female patient with no significant comorbidities presented with a history of low-grade intermittent fever and dry cough for one-month duration complicated with hemoptysis for two days. Her initial investigations and imaging were negative, except for the high-resolution CT (HRCT) finding of bronchiectasis involving the middle lobe and lingula lobe suggestive of MAC infection, which was further confirmed by positive sputum culture for MAC. LWS is a condition that is rarely encountered in clinical settings and seldom described in the literature. Especially in resource-limited settings, arriving at a diagnosis is further hindered by the scarce availability of advanced imaging such as HRCT. In clinical settings where pulmonary tuberculosis is endemic, the differentiation of the two conditions is of paramount importance as the treatment regimens for the two conditions are quite different.
摘要：
鸟分枝杆菌复合物(MAC)通常在免疫受损的个体中观察到。然而,当肺部MAC感染发生在有免疫能力的个体中时，尤其是老年女性，特征性涉及肺的中叶和舌叶，它被称为温德米尔夫人综合征（LWS）。一名64岁女性患者，无明显合并症，有低度间歇性发热和干咳病史，持续一个月，并伴有咯血两天。她的初步调查和影像学检查均为阴性，除了高分辨率CT（HRCT）发现支气管扩张涉及中叶和舌叶，提示MAC感染，MAC痰培养阳性进一步证实了这一点。LWS是一种在临床环境中很少遇到并且在文献中很少描述的病症。特别是在资源有限的环境中，由于缺乏诸如HRCT之类的高级成像技术，进一步阻碍了诊断。在肺结核流行的临床环境中，区分这两种情况是最重要的，因为这两种情况的治疗方案完全不同。
