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ImagesinClinicalMedicineLeft-Middle-LobePneumoniaLingYuanKong,YvesLongtinNEnglJMed;:e8DOI:10./NEJMicmA34-year-oldmanpresentedtotheemergencydepartmentwitha5-dayhistoryoffever,cough,anddyspnea.Hehadreceivedadiagnosisofsitusinversuswhenhewas2yearsofage,afterachestradiographhadbeenobtainedinordertoevaluateacough.Physicalexaminationwasnotableforheartsoundsintherightsideofhischestandforcracklesinthemiddlefieldoftheleftlung.Radiographyofthechestrevealedacardiacapex,aorticarch,andgastricbubbleintherightsideofthebodyandalobarinfiltrateintheleftlung.Aleft-middle-lobepneumoniawasdiagnosed.Thepatientreportedthathehadhadchroniccoughandrecurrentsinusitissincechildhood,andhealsoreportedinfertility—conditionsthatsuggestadiagnosisofKartagener’ssyndrome,whichischaracterizedbysitusinversus,recurrentsinusitis,andbronchiectasis(whichwasnotseenonhischestradiograph).Thissyndromeisaformofprimaryciliarydyskinesia,anautosomalrecessiveconditionthatiscausedbymutationsingenesencodingciliary浠�涔堟槸鐧界櫆椋庡浘鐗?鐧界櫆椋庡浘鐗?
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