A 25-year-old woman was admitted to our hospital because of recurrent pneumonia of the left upper lobe. Previous chest radiographs showed increased radiolucency of the left upper and middle lung fields, and pulmonary ventilation and perfusion scintigraphy at admission showed markedly decreased ventilation and perfusion in the left upper lobe. We diagnosed Swyer-James syndrome on the basis of these findings. Intravenous antibiotics failed to adequately improve the pneumonia; therefore, we performed a left upper lobectomy. Pathological findings of the resected lung showed bronchopneumonia with neutrophil infiltration and fibrosis, and a narrowing of the bronchus with endobronchial fibrosis containing islands of epithelial tissue or submucosal gland ducts. Pseudomonas aeruginosa was isolated from purulent pleural effusion and the resected lung tissue. We speculate that constrictive bronchitis and decreased perfusion caused the failure of antibiotic therapy.