Presentation
Chronic productive cough.
Patient Data
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Tubulocystic dilatation of bronchial tree in the middle lobe and lingular lobes. Bronchial wall thickening. Multifocal patchy air space consolidations in both lungs. Diffuse tree in bud branchings involving both lungs, more predominantly in the lower lobes.
Few mediastinal enlarged lymph nodes.
Bilateral moderate pleural effusions.
Dextrocardia and right-sided aortic arch.
Liver positioned in the left side and spleen on the right side (situs inversus).
Pulmonary artery dilated measuring 35mm in short axis. Right heart chambers and inferior vena cava are dilated.
Case Discussion
Situs inversus in association with bronchiectasis should prompt the diagnosis of Kartagener syndrome. There is also a superadded infectious process.
This case is contributed by Dr Naqibullah Foladi and Dr M.M.S. Hoshang.