Kartagener syndrome with pulmonary mycetoma and recurrent thromboembolism: A case report.
Muhammad Asghar Khan, Okasha Tahir, Abbas Khan et al.
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Case in brief
A 27-year-old man with Kartagener syndrome and situs inversus totalis presented with worsening dyspnea, chest pain, fever, hemoptysis, and ankle swelling, against a history of deep vein thrombosis, recurrent pulmonary embolism, and chronic productive cough. Imaging showed a right upper-lobe cavity indicative of pulmonary mycetoma, hepatic congestion, and ascites. Echocardiography revealed severe biventricular dysfunction, a right ventricular thrombus, pericardial effusion, and an ejection fraction of about 40%. U1-RNP antibodies were positive, but criteria for an autoimmune diagnosis were not met. He received heart failure management, anticoagulation, antifungals, and multidisciplinary care; no causal link among the conditions was established.
What made this case unusual
The case combined Kartagener syndrome with pulmonary mycetoma, recurrent thromboembolism, right ventricular thrombus, cardiac dysfunction, and positive U1-RNP serology without a confirmed autoimmune diagnosis.
Diagnostic / clinical pearl
In a patient with Kartagener syndrome and cardiopulmonary symptoms, assess for concurrent infectious and thromboembolic complications as well as cardiac dysfunction; positive U1-RNP serology alone did not establish an autoimmune diagnosis in this case.
Why it matters
The report highlights the value of multidisciplinary evaluation when congenital disease coexists with acquired infectious, thromboembolic, and cardiac complications.