A 19 year old man attends the chest clinic due to a persistent chest infection. He is a tall, thin, non-smoking man with a persistent cough productive of sputum. He has a few crackles at his left base, and quiet heart sounds. This is his CXR:
There's definitely something going on here...
He then goes on to have a CT scan of the chest and abdomen, as shown:
What is the abnormality here?
Can you spot the abnormality on this CT Abdomen?
1. What is the unifying diagnosis?
Kartagener’s syndrome.
2. What is the cause of his pulmonary symptoms?
He has localised bronchiectasis in the lingula.
3. What are the other parts of the syndrome?
The full spectrum of Kartenager’s syndrome is caused by ciliary dyskinesia: bronchiectasis; chronic sinusitis; and azoospermia. There is also situs inversus, as seen in the CXR, CT chest and CT abdomen. Remember that dextrocardia is common, but situs inversus is rare.
