Abstract
Bronchiectasis is a common precursor to a patient developing a Mycobacterium avium complex (MAC) infection. Patients that are affected by MAC infections, typically have an underlying form of pulmonary disease. Often times, Lady Windermere Syndrome (LWS) is diagnosed when a patient presents with a MAC infection following right middle lobe or lingular bronchiectasis. LWS presents most commonly in female patients that are tall and slender who are lifetime non-smokers. These patients voluntarily suppress their cough, which causes a reduced clearance of secretions from the right middle lobe and lingular lobe that have narrowed bronchi. Due to this, subsequently can lead to becoming infected with MAC. Mycobacteria are found in various organic reservoirs throughout the United States. Mainly, mycobacteria are found in soil and water. Well-known sources of water include, lakes, pools and hot tubs. Mycobacteria are thicker cell wall that makes them resistant to heavy metals, disinfectants and antibiotics. This is a case report outlining a patient in a pulmonary clinic that presented with a mildly productive cough and shortness of breath with exertion. Her history was significant for 2 recent bouts of pneumonia. She was a tall, slender lifetime non-smoker. The patient noted that she uses her pool daily. Throughout this case report, MAC, LWS as well as bronchiectasis are described in detail and the specific treatments are discussed.