Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis
Barclay, Mhairi Daniel, Mat
Barclay, Mhairi
Daniel, Mat
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. Copyright © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
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2022
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Barclay, M., Buderi, S., Bush, A., Daniel, M., Jordan, S., Rice, A., Ruggins, N., Semple, T. and Smyth, A.R. (2022) 'Wheeze in the time of COVID-19: overcoming obstacles to an unusual diagnosis', Thorax, 77(10), pp. 1050-1053. doi: 10.1136/thoraxjnl-2021-218526 https://doi.org/10.1136/thoraxjnl-2021-218526.
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Available to view on the publisher's website here: https://doi.org/10.1136/thoraxjnl-2021-218526.