Pertussis is a potentially severe disease, especially in infancy. The case of an 8-month-old infant is described who presented the typical radiographic image of unilateral hyperlucent lung or Swyer-James (MacLeod's) syndrome. The infant suffered from pertussis at 20 d of age. A rare postinfectious complication of pertussis is reported.

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http://dx.doi.org/10.1080/0036554031000027017DOI Listing

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Swyer-James-MacLeod syndrome (SJMS) also known as hyperlucent lung syndrome is a condition that occurs as a complication of infectious bronchiolitis obliterans. It is characterized by inflammation and fibrosis of the affected area of the lung resulting in ventilation and perfusion mismatch ultimately leading to underdevelopment of the affected lung. A key feature used for diagnosis is unilateral small lung with hyperlucency on a chest radiograph.

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Article Synopsis
  • Swyer-James-MacLeod syndrome (SJMS) is a rare lung disorder that leads to underdeveloped blood vessels in the lungs, often causing emphysema and sometimes bronchiectasis.
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  • A report of a 23-year-old Kenyan woman illustrates the challenges of diagnosing SJMS given her lengthy clinical history of respiratory issues, emphasizing the need for careful evaluation and possibly advanced imaging to identify the condition.
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We present a rare finding on lung ventilation-perfusion (V/Q) scintigraphy for a woman with longstanding dyspnea. CT of the chest showed volume loss on the right side, which raised concern about possible bronchiolitis obliterans or Swyer-James-MacLeod syndrome; however, the right pulmonary artery could not be visualized. A subsequent V/Q scan showed absence of perfusion and decreased ventilation to the entire right lung, consistent with agenesis of the right pulmonary artery.

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  • Swyer-James-MacLeod syndrome makes one lung lobe look really empty on chest scans, and it is linked to other lung problems like air trapping and less blood flow.
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Increased lung field permeability in young patients.

Clin Case Rep

August 2024

Department of Respiratory Medicine Ohara Healthcare Foundation, Kurashiki Central Hospital Okayama Japan.

When the chest radiograph of a young patient shows lung hyperlucency, it is important to obtain a detailed clinical history of any previous episodes of childhood infection. Previous chest radiographs should be reviewed to determine whether the condition is congenital or acquired, and thus assist in a diagnosis of SJMS.

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