A case of bronchiectasis presenting to emergency deparment with symptoms of rare entity “lady windermere syndrome”

Introduction Reich and Johnson (1) first used the term “Lady Windermere syndrome”in 1992. They described 6 elderly women who were immunocompetent, had no significant smoking history or underlying pulmonary disease, and developed Mycobacterium avium complex (MAC) pulmonary infection limited to the right middle lobe or lingula. They hypothesized that these women could have had the habit of voluntary suppression of cough, responsible for the inability to clear the secretions from the right middle lobe and lingula. This habit results in a focus of inflammation in these areas, which in turn predisposes to MAC infection. They named this condition Lady Windermere syndrome after Oscar Wilde's Victorian-era play Lady Windermere's Fan to suggest the fastidious behavior. Because it was a retrospective study, no history of voluntary cough suppression was obtained from these patients. We report a similar case in a 51-year-old woman who had bronchiectasis and associated right lower lobe infection due to MAC. Our patient had a significant history of lifelong habitual voluntary cough suppression.