Lady Windermere syndrome after cardiac surgery procedure: a case of Mycobacterium avium complex pneumonia

Area of Science:

• Pulmonary Medicine
• Infectious Diseases
• Cardiothoracic Surgery

Background:

• Lady Windermere syndrome is a rare lung infection.
• Coronary bypass operations can lead to sternal pain and the use of antitussive drugs.
• Antitussive overuse in patients with poor lung drainage can precipitate Mycobacterium avium complex colonization.

Observation:

• A patient developed Lady Windermere syndrome post-coronary bypass.
• The patient self-medicated with high doses of antitussives to manage post-sternotomy cough pain.
• Symptoms were insidious, mimicking bronchitis, leading to an 18-month diagnostic delay.

Findings:

• Lady Windermere syndrome developed due to Mycobacterium avium complex colonization.
• Prolonged antitussive use contributed to the infection in a poorly drained lung.
• Delayed diagnosis prolonged the patient's suffering and potential for complications.

Implications:

• Highlights the importance of adequate pain management post-median sternotomy.
• Emphasizes the need for early diagnosis of lung infections in post-cardiac surgery patients.
• Underscores the risks of chronic inflammation and infection from inadequate post-operative care.