B47-38 Delayed Diagnosis of Kartagener Syndrome Complicated by Tuberculosis

Abstract Introduction Kartagener syndrome is a rare, autosomal recessive disorder, occurring in nearly 50% of patients of primary ciliary dyskinesia and is characterized by situs inversus, bronchiectasis and chronic sinusitis. Age at presentation is most often during the first decade of life. Case Description A 37-year-old man, presented with a history of productive cough and low-grade fever for three weeks. His past clinical history was significant for chronic rhinosinusitis, occasional epistaxis and ear discharge since childhood. No history of prior hospital admission. He was married for 4 years but had no child. Clinical examination revealed cervical lymphadenopathy, mild clubbing of fingers, heart sounds were best heard on the right side and coarse expiratory crackles were heard in basal lungs. Complete blood count revealed mild microcytic hypochromic anemia and leukocytosis with neutrophilia. Chest x-ray confirmed situs inversus and raised bronchovascular markings in lower zones. X-ray paranasal sinuses showed polypoid mucosal thickening in maxillary and frontal sinuses. X-ray mastoids reveal sclerosis in bilateral mastoid air cells. CT chest revealed bronchiectasis with luminal content in bilateral lower zones. Multiple centrilobular nodules with tree-in-bud pattern were seen. Sputum examination was positive for acid fast bacilli. Based on clinical and radiological findings, a diagnosis of Kartagener’s syndrome with tuberculosis was made. He was managed with an anti-tubercular multidrug regime and has shown improvement of his symptoms on 6-month follow-up. Discussion Delayed presentation of Kartagener Syndrome in the late 30s, coupled with a concurrent tubercular infection, highlights the risk of missed or late recognition of the condition and its potential role as a predisposing factor for secondary infections. As Kartagener syndrome can affect immunity due to impaired mucociliary clearance, early screening and proactive management of the condition are crucial to prevent secondary infections, complications and improve clinical outcomes. This abstract is funded by: None