RT Journal Article
SR Electronic
T1 Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 1050
OP 1053
DO 10.1136/thoraxjnl-2021-218526
VO 77
IS 10
A1 Mhairi Barclay
A1 Silviu Buderi
A1 Andrew Bush
A1 Mat Daniel
A1 Simon Jordan
A1 Alexandra Rice
A1 Nigel Ruggins
A1 Thomas Semple
A1 Alan Robert Smyth
YR 2022
UL http://thorax.bmj.com/content/77/10/1050.abstract
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.