Presentation
Chronic sinusitis since childhood, routine check-up.
Patient Data
CXR demonstrates situs inversus (right sided heart, aorta and stomach bubble). Striking bilateral peribronchial cuffing and dilated bronchial tree, mainly in upper and lower lobe on the left side.
CT confirms situs inversus (mirror image of thoracic and upper abdominal content). The lung window setting the varicose to cystic bronchiectasis is well demonstrated. Also, the tree-in-bud sign is well visible in both lower lobes suggests current endobronchial infection.
Case Discussion
Kartagener syndrome describes a triad of:
situs inversus
bronchiectasis
chronic sinusitis
Immotile cilia syndrome is an autosomal recessive hereditary disease and a cause of Kartagener syndrome that may also present with subfertility.
Mucus plugging with bronchoceles and tree-in-bud sign is often associated with Kartagener Syndrome.
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