Infectious Causes of Right Middle Lobe Syndrome

• Published in: Cancer control Vol. 24; no. 1; pp. 60 - 65
• Main Authors: Rashid, Aatif, Nanjappa, Sowmya, Greene, John N
• Format: Journal Article
• Language: English
• Published: United States 01.01.2017
• Subjects: Anti-Bacterial Agents - therapeutic use; Aspergillosis, Allergic Bronchopulmonary - complications; Bronchodilator Agents - therapeutic use; Female; Humans; Middle Aged; Middle Lobe Syndrome - drug therapy; Middle Lobe Syndrome - etiology; Mycobacterium avium Complex - pathogenicity; Mycobacterium avium-intracellulare Infection - drug therapy; Mycobacterium avium-intracellulare Infection - microbiology; Prognosis
• ISSN: 1073-2748; 1526-2359; 1073-2748
• DOI: 10.1177/107327481702400110

Right middle lobe (RML) syndrome is defined as recurrent or chronic obstruction or infection of the middle lobe of the right lung. Nonobstructive causes of middle lobe syndrome include inflammatory processes and defects in the bronchial anatomy and collateral ventilation. We report on 2 case patients with RML syndrome, one due to infection with Mycobacterium avium complex followed by M asiaticum infection and the other due to allergic bronchopulmonary aspergillosis. A history of atopy, asthma, or chronic obstructive pulmonary disease has been reported in up to one-half of those with RML. The diagnosis can be made by plain radiography, computed tomography, and bronchoscopy. Medical treatment consists of bronchodilators, mucolytics, and antimicrobials. Patients whose disease is unresponsive to treatment and those with obstructive RML syndrome can be offered surgical treatment.