Atypical Kartagener syndrome in a 40-year-old woman: Computed Tomography findings of situs inversus with bronchiectasis and infertility

Abstract

Primary ciliary dyskinesia is a rare inherited disorder characterized by impaired mucociliary clearance leading to recurrent respiratory infections. Kartagener syndrome represents a subset of this condition classically defined by the triad of bronchiectasis, chronic sinusitis, and situs inversus, although atypical presentations lacking one component of the triad may occur. We report the case of a 40-year-old female who presented with productive cough, shortness of breath, chest pain, and fever, with a long-standing history of recurrent respiratory infections since adolescence that showed only temporary response to antibiotic therapy. The patient also reported primary infertility. Computed tomography of the chest demonstrated dextrocardia with complete situs inversus, bilateral bronchiectasis predominantly involving the middle and lingular lobes, mucus impaction, and associated tree-in-bud nodularity with ground-glass opacities. There was no clinical or radiologic evidence of sinusitis. These findings are consistent with an atypical presentation of Kartagener syndrome. This case highlights the importance of recognizing characteristic imaging features and considering underlying ciliary disorders in patients with recurrent respiratory infections and situs anomalies, even in the absence of sinus disease.