Lady Windermere syndrome: Middle lobe bronthiectasis and Mycobacterium avium complex infection due to voluntary cough suppression

An 81-year-old woman who presented with middle lobe bronchiectasis and Myco bacterium avium complex infection is described. She had a history of habitu al suppression of cough, as in Lady Windermere syndrome. She was thin and h ad mild kyphoscoliosis but had no history of smoking or connective tissue d isease. The middle lobe and lingula are predisposed to chronic inflammation because of their particular anatomic structures. Inability to clear the se cretions from the airway due to voluntary cough suppression may predispose to bronchiectasis and M. avium complex infection.