A 41-year-old man previously diagnosed with asthma presented with an influenza-like illness and breathlessness. He was treated for moderate-to-severe COVID-19 and exacerbation of asthma. CT pulmonary angiography (CTPA) revealed asymmetrical peribronchovascular ground-glass infiltrates consistent with COVID-19 and right main bronchial wall thickening with high-density material thought to be consistent with mucous impaction (figure 1A). He was discharged 8 days after admission. Figure 1 (A) Coronal view of CT pulmonary angiography (CTPA) performed on the first acute presentation of COVID-19 infection showing the appearance of high-density material with septations thought to be consistent with the appearance of mucous impaction associated with bronchial wall thickening in the right main bronchus (RMB). (B,C) Coronal and axial views of CTPA performed on second acute presentation with haemoptysis showing the high-density material and progression of bronchial wall thickening in the RMB. (D) Coronal view of low-dose CT chest performed 6 months after rigid bronchoscopy and foreign body extraction showing resolution of changes. At review 4 months later, he reported ongoing breathlessness and cough productive of green sputum. …

中文翻译：

---

并非所有喘息都是哮喘

一名 41 岁男性曾被诊断患有哮喘，出现类似流感的症状并伴有呼吸困难。他因中度至重度 COVID-19 和哮喘恶化而接受治疗。CT 肺血管造影 (CTPA) 显示不对称的支气管血管周围毛玻璃样浸润，与 COVID-19 一致，右主支气管壁增厚，有高密度物质，被认为与粘液嵌塞一致（图 1A）。入院8天后出院。图 1 (A) 在首次出现 COVID-19 感染急性症状时进行的 CT 肺血管造影 (CTPA) 冠状视图显示出现高密度物质并伴有间隔，被认为与支气管壁增厚相关的粘液嵌塞的外观一致位于右主支气管 (RMB)。(B,C) 第二次急性咯血时进行的 CTPA 冠状面和轴向视图显示人民币中的高密度物质和支气管壁增厚的进展。(D) 硬质支气管镜检查和异物取出后 6 个月进行的低剂量 CT 胸部冠状视图显示变化已解决。4 个月后复查时，他报告持续呼吸困难和咳嗽并咳出绿色痰液。……