Late diagnosis of Kartagener syndrome in a 38-year-old female presenting with palpitations in a resource-limited emergency department

TL;DR

A 38-year-old woman with Kartagener syndrome was diagnosed in a resource-limited emergency department using basic tools and clinical observation.

Contribution

This case highlights the possibility of diagnosing Kartagener syndrome in adults using simple diagnostic methods in low-resource settings.

Findings

Kartagener syndrome was diagnosed in an adult using dextrocardia on ECG and chest radiography.

Basic diagnostic tools and clinical features can lead to accurate diagnosis in resource-limited environments.

The case emphasizes the importance of diagnostic vigilance in adult patients with atypical presentations.

Abstract

Kartagener syndrome, a subset of primary ciliary dyskinesia, is typically diagnosed in childhood due to its classic triad of situs inversus, chronic sinusitis, and bronchiectasis. We report a compelling case of a 38-year-old woman from a remote village who presented to our emergency department with palpitations, dyspnea, and reflux. All symptoms resolved with rest and PPIs. Routine investigations revealed dextrocardia on ECG and chest radiography. Despite a limited history of hospital visits, she had a known history of nasal polyps, chronic cough with mucus expectoration, and recurrent bronchitis. A clinical diagnosis of Kartagener syndrome was made based on clinical features and basic diagnostic tools. This case underscores the importance of maintaining diagnostic vigilance in adult patients and highlights the potential for accurate diagnosis even in resource-constrained settings. It emphasizes how physical examination and plain radiography can reveal significant diagnostic clues, even in the absence of advanced investigations.

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