@article {Barclay1050, author = {Mhairi Barclay and Silviu Buderi and Andrew Bush and Mat Daniel and Simon Jordan and Alexandra Rice and Nigel Ruggins and Thomas Semple and Alan Robert Smyth}, title = {Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis}, volume = {77}, number = {10}, pages = {1050--1053}, year = {2022}, doi = {10.1136/thoraxjnl-2021-218526}, publisher = {BMJ Publishing Group Ltd}, 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.}, issn = {0040-6376}, URL = {https://thorax.bmj.com/content/77/10/1050}, eprint = {https://thorax.bmj.com/content/77/10/1050.full.pdf}, journal = {Thorax} }