Lady Windermere syndrome

An 81-year-old woman, with hypertension and dyslipidaemia, was admitted with an 8-month history of intermittent episodes of persistent cough, occasionally productive of yellowish sputum, and mild exertional dyspnoea, associated with malaise and 10 kg weight loss, but no fever or night sweats related. She was diagnosed as having chronic bronchitis and community-acquired pneumonia, receiving several courses of different empiric antibiotics, like amoxicillin and azithromycin with little improvement. On admission, she looks malnourished, weight 47 kg, body mass index 17 kg/m2, arterial pression 126/60 mm Hg, heart rate 78 per minute, respiratory rate 22 per minute and temperature 36.5°C. On physical examination, the only positive finding was diffuse wheezing and rhonchi, with bibasilar rales. A CT of the chest demonstrated multiple nodules of different sizes and diffuse distribution, some of them cavitated and with a pattern of ‘tree-in-bud’, associated with mediastinal lymphadenopathies, traction bronchiectasis in the middle lobe and lingula,...

Source: Postgraduate Medical Journal - November 22, 2022 Category: General Medicine Authors: Catano, J. C., Porras Mancilla, J. P. Tags: Images Source Type: research