Sarcoidosis Presenting as a Giant Pulmonary Bulla With Concurrent COVID-19 Infection
Krishnan, Sathish ; Naumaan, Anam ; Pararath Gopalakrishnan, Venu
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Abstract
Sarcoidosis is a systemic granulomatous disease that predominantly affects the lungs. However, its presentation as a giant pulmonary bulla is exceptionally rare. Its association with COVID-19 has raised new concerns regarding disease exacerbation and misdiagnosis. We report a case of a 38-year-old man who developed a large left lower lobe bulla in the context of recent COVID-19 infection. Initial misinterpretation of the bulla as loculated pneumothorax nearly led to an unnecessary chest tube placement. A subsequent thoracotomy with lobectomy revealed nonnecrotizing granulomas, confirming sarcoidosis. The patient showed spontaneous remission without requiring treatment. This case highlights the importance of multidisciplinary discussions in atypical lung presentations to prevent mismanagement.
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Krishnan S, Naumaan A, Pararath Gopalakrishnan V. Sarcoidosis Presenting as a Giant Pulmonary Bulla With Concurrent COVID-19 Infection. J Investig Med High Impact Case Rep. 2025 Jan-Dec;13:23247096251340738. doi: 10.1177/23247096251340738. Epub 2025 May 8. PMID: 40340503; PMCID: PMC12062588.