Intrapulmonary percussive ventilation for the management of destroyed lung in Swyer-James-MacLeod syndrome

Swyer-James-MacLeod syndrome (SJMS) is a rare disorder resulting from post-infectious bronchiolitis obliterans following lower respiratory tract infection in childhood and may be complicated by bronchiectasis. We report the case of a man in his 60s with a history of childhood pneumonia who was diagnosed with bronchiectasis associated with SJMS. Against a background of chronic Pseudomonas aeruginosa airway infection, progressive structural destruction of the left lung eventually resulted in a destroyed lung. Prior to the introduction of intrapulmonary percussive ventilation (IPV), the patient required hospitalisation for disease management. Following the initiation of IPV, however, he remained free from hospitalisation for 11 years while maintaining independent functional status. This case illustrates a possible natural history of SJMS-associated bronchiectasis progressing to a destroyed lung and suggests that conservative management centred on appropriate airway clearance, including IPV, may contribute to favourable long-term outcomes and the preservation of functional independence, even in patients with advanced structural lung disease.