Kartagener's Syndrome

A 36-year-old man presented to a respiratory medicine clinic for evaluation of a cough and yellow, purulent sputum for > 20 years. The cough had worsened since asthma was diagnosed 3 months prior. He had a history of chronic sinusitis. The physical examination showed that the heart was within the right thorax. A chest radiograph showed increased lung texture with multiple cystic translucencies in both lungs (Figure 1, white arrow) and transposition of the heart (Panel A, blue arrow). Computed tomography (CT) of the chest revealed bronchiectasis (Panel B, white arrow) and a right-sided heart (Panel B, blue arrow). An abdominal color ultrasound showed that the liver was situated on the left and the spleen was situated on the right. In addition, CT of the head showed mucosal thickening (Panel C, white arrow) and a low-density shadow filling the paranasal sinuses (Panel C, blue arrow). Kartagener's syndrome is a hereditary disease with the following typical symptoms: situs inversus; bronchiectasis; and chronic infections of the nasal mucosa. Bronchiectasis and recurrent lung infections can develop into end-stage lung diseases. The patient underwent a double lung transplant and was discharged in stable condition 1 month postoperatively. The patient was doing well at the 5-year follow-up evaluation. Panel D shows the most recent chest CT scan.