Kentucky.

Swyer-James syndrome is a pulmonary condition acquired following bronchiolitis obliterans early in life. Clinically characterized by repeated bouts of pulmonary infections, Swyer-James syndrome is characterized radiographically by a unilateral small, hyperlucent lung that demonstrates diminished arterial supply to the involved lung, air-trapping, and bronchiectasis. Radioimaging procedures may reveal otherwise unsuspected bilateral involvement. A 14-year-old Caucasian female with classic findings of Swyer-James syndrome is presented. The differential diagnosis of conditions that may present with a unilateral hyperlucent lung is discussed. Therapy is aimed primarily at control of the intercurrent episodes of bacterial pneumonia. Hlr SWYER-JAMES SYNDROME, synonymous with MacLeod’s syndrome * and unilateral hyperlucent lung syndrome, ~ is one of several causes of a unilateral hyperlucent (hypertransradiant) lung. Swyer-James syndrome is an acquired pulmonary condition that fol-lows bronchiolitis obliterans in infancy.2~5 After the initial pulmonary infection, which is usually viral in etiology, these patients are prone to develop repeated episodes of bacterial pneumonia and bronchiectasis in the involved lung. The diagnosis is frequently made during childhood in patients who are symptomatic; however, some patients are relatively asymptomatic and the diagnosis may not be made until later life when a radiograph is obtained for other reasons. 1,6-8 We wish to report a patient with a history of repeated pulmonary infection dating from early childhood who demonstrated classical findings of the Swyer-james syndrome. The etiology, diagnostic criteria, and sub-sequent management of patients with Swyer-James syndrome are discussed. Conditions that must be dif-ferentiated from Swyer-James syndrome also are enu-merated