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Lady Windermeres Fächer ist eine Gesellschaftskomödie in vier Akten des irischen Schriftstellers Oscar Wilde. Die Uraufführung des Bühnenstücks fand am Februar im St. James's Theatre in London statt. Knapp ein Jahr später, am 5. Originaltitel: Lady Windermere's Fan Uraufführung: St. James's Theatre,London, Februar , mit George Alexander als Lord Windermere und Marion Terry​. Stella Erlynne wird von Windermere gezwungen, Amalfi zu verlassen. Die Windermeres sind somit wieder versöhnt. Beim Verlassen der Amalfiküste mit dem. Indem er versucht Lady Windermere von ihren strengen moralischen Prinzipien abzubringen, handelt er nicht mit der Intention einer Kritik der Viktorianischen. Simone Linde. Dekadenz und Ästhetizismus in Oscar Wildes Gesell- schaftskomödie "Lady Windermere´s Fan". GRIN Verlag.

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Sign Up. Become a Gold Supporter and see no ads. Log in Sign up. Articles Cases Courses Quiz. About Blog Go ad-free. Imaging of pulmonary infections.

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URL of Article. Article information. System: Chest. Tag: syndrome. Synonyms or Alternate Spellings: Lady Windermere's syndrome.

Cases and figures. Case 1 Case 1. Middle lobe bronchiectasis had been documented by CT 3 years earlier. She had never smoked.

She was socially active and gave a history of lifelong habitual voluntary cough suppression, especially in the presence of others.

Physical examination revealed a thin woman in no apparent distress. She had mild kyphoscoliosis but no pectus deformity of her chest wall.

Other significant findings were decreased breath sounds with crackles in the right middle and lower lung zones. A low-grade fever was documented on and off during the hospital stay.

A chest radiogram revealed a right middle lobe infiltrate and a small right pleural effusion figure 1. CT of the chest revealed localized bronchiectasis in the right middle lobe figure 2.

A two-dimensional echocardiogram showed aortic sclerosis and left ventricular dysfunction but no mitral valve prolapse. Posteroanterior chest radiogram of a woman with Lady Windermere syndrome that shows a right middle lung infiltrate and a small right pleural effusion.

CT scan of a woman with Lady Windermere syndrome that shows localized bronchiectasis in the right middle lobe. Bronchoscopy revealed no endobronchial lesion, and the right middle lobe opening was not narrow or acutely angled.

Analysis of a smear of bronchoalveolar lavage fluid was negative for acid-fast bacilli, and culture of this fluid eventually yielded MAC.

The patient was treated with clarithromycin, rifampin, and ethambutol. She had significant improvement in her condition and completed a 2-year course of treatment without any major side effects.

Reich and Johnson [ 1 ] described 6 patients with MAC infection involving only the lingula or middle lobe of the right lung.

Iseman et al. The middle lobe and lingula have in common long, narrow, and in an upright position dependent bronchi that predispose them to infection.

On the basis of the frequent presence of a specific phenotype, thoracic abnormalities, and mitral valve prolapse, in addition to problems of collateral ventilation due to the frequent presence of complete or partially complete fissures, these researchers proposed that this syndrome might be a connective tissue disorder.

They also believed that the thoracic skeletal abnormalities could result in decreased sputum clearance and ineffective cough mechanisms, also contributing to progression of the disease.

Several studies have reported that most women with thoracic skeletal abnormalities and MAC pulmonary infection are thin [ 1 , 4 , 5 ]. Reich and Johnson [ 1 ] hypothesized that women are more likely to regard expectoration as socially unacceptable behavior and thus indulge in habitual voluntary cough suppression.

This voluntary cough suppression leads to an inability to clear secretions especially from the middle lobe and lingula , which results in a chronic nidus for inflammation that favors subsequent infection by MAC.

Sufficient previously reported data on voluntary cough suppression are not available. However, it has been shown that this entity does exist and that cough induced by inhalation of capsaicin can be voluntarily suppressed [ 7 ].

Wells et al. Bronchoscopy revealed copious secretions in the airways of 3 of these patients. Byrd et al. It is not clear whether they had a history of habitual cough suppression.

Our patient was a retired schoolteacher and considered it impolite to cough in public. She had a lifelong history of suppressing her cough.

She also had the typical phenotype described by Iseman et al. It appears that the middle lobe and lingula are predisposed to nonspecific inflammation because of their particular anatomic structures and absence of collateral ventilation.

Most of the patients with nonobstructive middle lobe syndrome due to MAC seem to be thin elderly women for whom the prevalence of abnormalities of the chest wall and thoracic spine is high.

A diminished cough reflex due to the abnormal bony cage may further predispose the middle lobe and lingula to chronic inflammation and infection.

The concept of voluntary cough suppression cannot be ignored. This entity occurs predominantly in women and may result in an inability to clear secretions from the middle lobe and lingula.

Our patient had a history of lifelong habitual cough suppression. To the best of our knowledge, we report the first case of bronchiectasis and middle lobe syndrome due to MAC in which a history of habitual voluntary cough suppression was elicited.

Thus, she is the first patient with a bona fide diagnosis of Lady Windermere syndrome as defined by Reich and Johnson [ 1 ]. The exact prevalence of habitual cough suppression among such patients and, as a matter of fact, among all patients with nonobstructive middle lobe syndrome is unknown and needs to be studied.

It is possible that with appropriate behavior modification, this disease can be prevented. Google Scholar. Oxford University Press is a department of the University of Oxford.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account.

Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract.

Case Report. Reprints or correspondence: Dr. Watanakunakorn, St. Oxford Academic.

Sufficient previously reported data on voluntary cough suppression are not available. However, it has been shown that this entity does exist and that cough induced by inhalation of capsaicin can be voluntarily suppressed [ 7 ].

Wells et al. Bronchoscopy revealed copious secretions in the airways of 3 of these patients. Byrd et al. It is not clear whether they had a history of habitual cough suppression.

Our patient was a retired schoolteacher and considered it impolite to cough in public. She had a lifelong history of suppressing her cough.

She also had the typical phenotype described by Iseman et al. It appears that the middle lobe and lingula are predisposed to nonspecific inflammation because of their particular anatomic structures and absence of collateral ventilation.

Most of the patients with nonobstructive middle lobe syndrome due to MAC seem to be thin elderly women for whom the prevalence of abnormalities of the chest wall and thoracic spine is high.

A diminished cough reflex due to the abnormal bony cage may further predispose the middle lobe and lingula to chronic inflammation and infection. The concept of voluntary cough suppression cannot be ignored.

This entity occurs predominantly in women and may result in an inability to clear secretions from the middle lobe and lingula.

Our patient had a history of lifelong habitual cough suppression. To the best of our knowledge, we report the first case of bronchiectasis and middle lobe syndrome due to MAC in which a history of habitual voluntary cough suppression was elicited.

Thus, she is the first patient with a bona fide diagnosis of Lady Windermere syndrome as defined by Reich and Johnson [ 1 ].

The exact prevalence of habitual cough suppression among such patients and, as a matter of fact, among all patients with nonobstructive middle lobe syndrome is unknown and needs to be studied.

It is possible that with appropriate behavior modification, this disease can be prevented. Google Scholar. Oxford University Press is a department of the University of Oxford.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation.

Volume Article Contents Abstract. Case Report. Reprints or correspondence: Dr. Watanakunakorn, St. Oxford Academic.

Chatrchai Watanakunakorn. Elizabeth Health Center. Select Format Select format. Permissions Icon Permissions. Abstract An year-old woman who presented with middle lobe bronchiectasis and Mycobacterium avium complex infection is described.

Open in new tab Download slide. Mycobacterium avium complex pulmonary infection presenting as isolated lingular or middle lobe pattern: the lady Windermere Syndrome.

Google Scholar Crossref. Search ADS. Infection with Mycobacterium avium complex in patients without predisposing conditions.

Mycobacterium avium -intracellulare pulmonary infection in HIV-negative patients without preexisting lung disease: diagnostic and management limitations.

Pectus excavatum and scoliosis: thoracic anomalies associated with pulmonary disease caused by Mycobacterium avium complex.

Resection of the right middle lobe and lingula for mycobacterial infection. Voluntary suppression of cough induced by inhalation of capsaicin in healthy volunteers.

Lady Windermere's syndrome: an atypical presentation of an atypical mycobacterium. Google Scholar PubMed. Issue Section:.

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Add comment Cancel. Submit a comment. Oscar Wildes Satire wurde mehrfach verfilmt. Die erste bekannte Hörspielfassung des Stückes entstand am 6.

September Eine Möglichkeit zur Aufzeichnung gab es erst ab Eine weitere Livesendung ging am Oktober auf Sendung. Weitere Angaben sind nicht überliefert.

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