Right Middle Lobe Syndrome??

My 19 month old son was just diagnosed 3 days ago with pneumonia for the 6th time since February. Except for this time, he has gotten it regularly at the beginning of the month for 5 months in a row. We have seen an infectious disease specialist who could not find the reason why he had recurrent pneumonia. Now we see a pulminologist who says it could be right middle lobe syndrome. Is this a serious illnesss? What is done with surgery to correct the problem?

[National Jewish Health]

The right middle lobe syndrome (RML Syndrome) is serious to the extent that it can predispose to recurrent infection, with all the risks that accompany an infection.  The recurrent infection may be on the basis of the middle lobe anatomy or anatomically limited local defense mechanisms, the latter possibly due to some permanent damage to the bronchial membranes and their ability to resist infection, at the time of the first pneumonia.

Another explanation could be infection with an atypical organism that has responded partially to therapy but has never completely resolved since the first pneumonia. The preceding is based on the assumption that the recurrent pneumonia has been only in the RML and not scattered throughout the lungs.

If this is not the case and other parts of his lungs have been infected, a more likely possibility would be that he has either a congenital or an acquired immunodeficiency state and should be tested for it.

The definitive treatment for the RML Syndrome is surgical removal of the RML and that would have no lasting effect on his lung function or his general health in the years to come.

You may want to request a second opinion from a Pediatric Pulmonologist.

Good luck