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Sarcoidosis Presenting as a Giant Pulmonary Bulla With Concurrent COVID-19 Infection

Krishnan, Sathish
Naumaan, Anam
Pararath Gopalakrishnan, Venu
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Case Report
Publication Date
2025-05-08
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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.

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DOI
10.1177/23247096251340738
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40340503
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Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).