A Case of Scimitar Syndrome Misdiagnosed as Pulmonary Tuberculosis: A Rare Congenital Anomaly with Implications for Clinical Practice

Background: Scimitar syndrome, also known as Veno-lobar syndrome, is a rare congenital malformation described by partial anomalous pulmonary venous return (PAPVR) from the right lung to the inferior vena cava (IVC). This condition is often associated with right lung hypoplasia or agenesis, presenting significant diagnostic challenges due to its similarity to other pulmonary conditions. Case presentation & management: We report the case of a 20-year-old asymptomatic female who was initially misdiagnosed with pulmonary tuberculosis (TB) based on incidental findings of right lung volume loss during a pre-travel medical evaluation. Following a month of anti-TB treatment without symptom resolution, advanced imaging studies revealed scimitar syndrome, highlighting the importance of differential diagnosis in similar cases. Conclusion: This case underscores the necessity of considering congenital anomalies like scimitar syndrome in the differential diagnosis of unilateral lung abnormalities, particularly in endemic regions for TB. Accurate diagnosis is critical for effective management and optimal long-term outcomes.