Sweyr-James-MacLeod syndrome: a case report

Swyer-James-MacLeod syndrome (SJMS) is a rare, acquired pulmonary disorder predominantly affecting children, characterized by unilateral hyperlucency of the lung, bronchiectasis, and recurrent respiratory symptoms. Timely diagnosis and intervention are critical to prevent long-term morbidity.

We present the case of an 11-year-old boy with a four-month history of recurrent productive cough, yellow sputum, and progressive respiratory distress. Despite multiple courses of antibiotics and expectorants, there was no clinical improvement. Chest X-ray and computed tomography revealed left lung hyperlucency, segmental bronchiectasis in the left lower lobe, and compensatory hyperinflation of the right upper lobe. Following the failure of conservative management, a left lower lobectomy was performed. Histopathology confirmed severe bronchiectasis with fibrosis and chronic inflammation, consistent with SJMS. The patient's symptoms improved significantly postoperatively.

This case highlights the importance of considering SJMS in children presenting with chronic respiratory symptoms and unilateral hyperlucency on imaging. Surgical intervention may be warranted in patients with localized disease unresponsive to medical therapy.

Early recognition and management of SJMS are essential to prevent irreversible lung damage. Lobectomy can be an effective treatment in selected cases with localized, severe disease.