Lady Windermere syndrome is a type of mycobacterial lung infection.
Patients with Lady Windermere syndrome experience chronic cough, shortness of breath, fatigue and other less specific symptoms.
Immunodeficiency is not a requirement for Mycobacterium avium infection.
Mycobacterium avium Complex (MAC) usually affects patients with abnormal lungs or bronchi. However, Jerome Reich and Richard Johnson describe a series of six patients with MAC infection of the right middle lobe or left lingula who did not have any predisposing lung disorders.
The right middle lobe and left lingula of the lungs are served by bronchi that are oriented downward when a person is in the upright position. As a result, these areas of the lung may be relatively more dependent upon vigorous voluntary expectoration (cough) for clearance of bacteria and secretions.
Since the six patients in their retrospective case series were older females, Reich and Johnson propose that patients without a vigorous cough may develop right middle lobe or left lingular infection with MAC. They propose that this syndrome be named Lady Windermere syndrome, after the character Lady Windermere in Oscar Wilde's play Lady Windermere's Fan.
The diagnosis requires consistent symptoms with two additional signs:
The original Chest article proposing the existence and pathophysiology of the Lady Windermere syndrome suggests that the character Lady Windermere in Oscar Wilde's Victorian-era play Lady Windermere's Fan is a good example of the fastidious behavior believed to cause the syndrome. The article states:
Victorian women presumably believed that "Ladies don't spit," and consequently might have been predisposed to develop lung infection.
Shortly after the Lady Windermere syndrome was proposed, a librarian wrote a letter to the editor of Chest challenging the use of Lady Windermere as the eponymous ancestor of the proposed syndrome. In Lady Windermere's Fan, Lady Windermere is a vivacious young woman, married only 2 years, who never coughs or displays any other signs of illness. While her avoidance of shaking hands might be interpreted as "fastidiousness," two alternative explanations may be just as probable:
The OScholars highlight the literary malapropism, but some in the medical community have adopted the term regardless, and peer-reviewed medical journals still sometimes mention the Lady Windermere syndrome.
In recent years, some have described the eponym as inappropriate, and some have noted that it would have been unlikely that Lady Windermere had the condition to which her name was assigned.