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Lady Windermere syndrome

Last revised by Dr Sonam Vadera on 13 May 2022

Lady Windermere syndrome refers to a pattern of pulmonary Mycobacterium avium complex (MAC) infection seen typically in elderly white women who chronically suppress the normal cough reflex. A fastidious nature and a reticence to expectorate are believed to predispose such persons to infections with MAC.

Radiographic features

Plain radiograph

Linear opacities in middle lobe or lingula can be seen, as a result of subsegmental atelectasis or bronchiectasis with mucosal impactions. Residual middle lobe or lingula atelectasis can also be seen.


Typical manifestation is of bronchiectasis, centrilobular nodules, tree-in-bud nodularity and eventual scarring and volume loss affecting the middle lobe and lingula 1

It is one of the causes of right middle lobe syndrome

History and etymology

The syndrome is named after Lady Windermere, a character in Oscar Wilde's 1892 play 'Lady Windermere's Fan' 2.

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Cases and figures

  • Case 1
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  • Case 2
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