PT  - JOURNAL ARTICLE
AU  - Mhairi Barclay
AU  - Silviu Buderi
AU  - Andrew Bush
AU  - Mat Daniel
AU  - Simon Jordan
AU  - Alexandra Rice
AU  - Nigel Ruggins
AU  - Thomas Semple
AU  - Alan Robert Smyth
TI  - Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis
AID  - 10.1136/thoraxjnl-2021-218526
DP  - 2022 Oct 01
TA  - Thorax
PG  - 1050--1053
VI  - 77
IP  - 10
4099  - http://thorax.bmj.com/content/77/10/1050.short
4100  - http://thorax.bmj.com/content/77/10/1050.full
SO  - Thorax2022 Oct 01; 77
AB  - 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.