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What Is The Cause And Treatment For Lady Windermere Syndrome?

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Posted on Mon, 3 Nov 2014
Question: I was dx with atypical mycobacterial infection. Final results aren't in but it seems to be MAC. Last December I developed a sore throat, achy, no fever, thyroiditis. A strange deep croup like cough developed. I saw an ENT who said I had larygopharyngeal reflux and to take PPI's and nasal spray. Also referred to Endocrinologist for throid. By the time I saw him, thyroid pain gone but cyst and multinodular nodes. Follow up was recommended. For a year I had on and off achiness, cough getting better. This past XXXXXXX July I developed tooth infection, took cipro 3 weeks. Cough left, achiness left. Tooth pulled, went off antibiotics and cough and tiredness returned. Blood cultures showed no infection. Slightly elevated RBC,HCT,MPV. EOS though went from .2 in 1-13-13 to 5.0 12-13 (when this occurred) to 8.0 9-4-14. Referred to allergist who ordered sputum tests which brought dx above. Infectious disease dr gave me Zithromax and ethambutol. Said he could treat with one antibiotic but wanted to knock it out faster with 2. Will do so for 2 months - he said I was a 1 out of 1-4 on sputum culture, tho something was still 'cooking'. Said OK to start on 1 for week and add the other. So Sat I started Zithromax (generic). I noticed a slight itching in ears, but told myself to ignore. 2 hrs later, diarrhea for 3 hrs with strange rumbling in stomach. Then I was fine, felt better, could eat, no more diarrhea. Being an 'allergic' person, I wonder if this is allergy to Zithromax. Was afraid to take next dose (due at 2 PM yesterday). It's 9:45 AM now in Florida. I'm scared. Ethambutol can cause blindness, 50%. My allergist Ofc just called and said they are adding Zithromax to med I had rxn to. Now I'm to call ID dr to ask for different antibiotic. Also my cat scan showed no evidence of consolidation, nodule, pneumothorax or effusion. Mild Biapical scarring. I have mild asthma (used to be worse) and a bout of pneumonia in 2000. Taking antibiotics for a year or more is scary. I don't feel bad, started coughing up sputum from lungs two weeks ago after neuromuscular therapist began knocking on ribs and lungs. He's the one who said go back to dr that started all this. Sorry for long msg. I think I may have gotten this last Sept after eating a takeout order from health food store, fish, strange greens, next morning severe all day diarrhea with rash that's been there since then - week later - felt thyroid cyst - then abt month later all the above happened (incubation period). Any better treatment for this? Should I be scared? I am 73, thought 'healthy' tho Vit D levels were low, lots of other nutrients borderline thru spectra cell analysis. I know I'm in XXXXXXX category but do want to return to health. Again, I know lots of info but could all be connected? Thank you for any help !! PS: please be open to nutritional support such as vitamin drips or anything new on horizon. Thanks
doctor
Answered by Dr. Sumit Bhatti (43 minutes later)
Brief Answer:
Rule out Lady Windermere Syndrome, review Chest CT

Detailed Answer:
Hi,

Thank you for your query.

1. If your cultures are positive for MAC, your signs and symptoms suggest a variant of the Lady Windermere Syndrome.

2. Get your Chest CT Scan reviewed. The changes are subtle and may be missed.

3. There are many antibiotics that can be used. If you are allergic to Zithromax, request a change. The recommended duration of treatment is more than a year and up to two years. Red-green color blindness is an early sign of Ethambutol toxicity, The visual defects can be avoided and may be reversible on early discontinuation of the drug. Monitoring is important in long term therapy.

4. Multi-nodular thyroid is common and nutritional deficiencies can be easily supplemented.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Is The Cause And Treatment For Lady Windermere Syndrome?

Brief Answer: Rule out Lady Windermere Syndrome, review Chest CT Detailed Answer: Hi, Thank you for your query. 1. If your cultures are positive for MAC, your signs and symptoms suggest a variant of the Lady Windermere Syndrome. 2. Get your Chest CT Scan reviewed. The changes are subtle and may be missed. 3. There are many antibiotics that can be used. If you are allergic to Zithromax, request a change. The recommended duration of treatment is more than a year and up to two years. Red-green color blindness is an early sign of Ethambutol toxicity, The visual defects can be avoided and may be reversible on early discontinuation of the drug. Monitoring is important in long term therapy. 4. Multi-nodular thyroid is common and nutritional deficiencies can be easily supplemented. Hope I have answered your query. If you have any follow up queries, I will be available to answer them. Regards.