Middle lobe syndrome- a rare but an important clinical entity

Middle lobe syndrome refers to a clinical condition that is characterized by recurrent or chronic collapse of the middle lobe of the right lung. Inefficient collateral ventilation, infection and inflammation in the middle lobe or lingula are thought to play a role in the pathogenesis of this condition. MLS can be obstructive or non-obstructive; the management varies according to the aetiology. Patients with proven endobronchial lesions or malignancy are usually offered surgical resection while most patients with non-obstructive aetiology respond to medical treatment consisting of bronchodilators, mucolytics and broad-spectrum antibiotics. We present a case of MLS who was managed conservatively in our ICU but did not respond and required surgical intervention later.