Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis

Mhairi Barclay*, Silviu Buderi, Andrew Bush, Mat Daniel, Simon Jordan, Alexandra Rice, Nigel Ruggins, Thomas Semple, Alan Robert Smyth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

This case is an example of a rare cause of a common clinical presentation (persistent lobar collapse with wheeze). We describe patient management from primary care through to a national thoracic referral centre. We highlight the importance of objective testing to support an asthma diagnosis and the need to consider alternative or additional diagnoses if a patient does not respond to treatment or the clinical course is unexpected. We highlight the importance of follow-up X-ray to determine whether atelectasis has resolved, which was significantly delayed in this case due to COVID-19 restrictions. Though rare, an endobronchial tumour should be considered if atelectasis persists and when planning endoscopy for a presumed foreign body, especially if the clinical history and patient factors make a foreign body less likely. Greater awareness of this as a differential may expedite diagnoses for patients in future. We show how virtual, multicentre, multidisciplinary meetings can aid rapid diagnosis, surgical planning and coordination of follow-up across centres.

Original languageEnglish
Pages (from-to)1050-1053
Number of pages4
JournalThorax
Volume77
Issue number10
Early online date29 Jun 2022
DOIs
Publication statusPublished - Oct 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
©

Keywords

  • Bronchoscopy
  • COVID-19
  • Histology/Cytology
  • Paediatric asthma
  • Paediatric Lung Disaese
  • Rare lung diseases
  • Thoracic Surgery

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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