An 18-year-old patient with a history of COVID-19 (1 month previously) was admitted with malaise and complaints of a stiff neck, a left-sided cervical mass, headache, and difficulty in swallowing and breathing, which had been present for 4 days. Two days after the onset of the first symptoms, a painless skin rash on the legs, arms, palms of both hands, and soles of both feet developed. Despite 2 days of treatment with antibiotics (amoxicillin/clavulanic acid, 500/125 mg three times daily orally), symptoms progressed. On presentation, the patient was alert and oriented, there were no neurologic disorders, and all symptoms related to the recent COVID-19 infection had subsided. His medical history was negative for sexually transmitted diseases, and the patient had received all vaccines except for meningococcus and COVID-19.

A 54-year-old man with chronic hepatitis B was admitted to the hospital with progressive dyspnea on exertion. He reported experiencing intermittent fever, dyspnea on exertion, and relapsing pleuritic chest pain starting 6 months prior, after his first dose of the ChAdOx1 nCoV-19 vaccine. In the past 2 months, he had been admitted to the hospital twice and diagnosed with recurrent pneumonia. Under antibiotic treatment, his dyspnea and low-grade fever demonstrated waxing and waning behaviors. Migratory pulmonary consolidation, which moved from the left lower lobe to the right middle lobe, was identified and diagnosed as relapsing pneumonia. Chest CT scan was performed in a previous admission 2 months earlier that revealed multifocal peripheral consolidation in the left lower lobe and right middle lobe. His occupation required the maintenance of overall fitness, and he denied immunosuppressant use, illicit drug abuse, cigarette smoking, suspicious travel, suspicious contact, or family history. No recent history of trauma, surgery, or air travel was reported.

A 60-year-old woman, a care worker with no known comorbidities, presented to the pulmonary clinic for assessment of a left hilar tumor detected on chest radiography. She had a history of oophorocystectomy and was a 0.5-pack/day smoker. She was asymptomatic but desired a confirmative diagnosis.

In July 2020, a previously healthy 6-year-old boy was evaluated in a pulmonary clinic in New York after two episodes of pneumonia in the previous 3 months. For each episode, the patient presented with cough, fever, and hemoptysis, all of which resolved with antibiotic therapy and supportive care. The patient never experienced dyspnea during these episodes of pneumonia. He was asymptomatic at the current visit. The patient had no history of travel, sick contacts, asthma, or bleeding disorders.

Although bilateral lung volume reduction surgery has been shown to be safe and effective in carefully selected patients with upper lobe-predominant emphysema and hyperinflation, bronchoscopic lung volume reduction via placement of endobronchial valves is conventionally performed only unilaterally. Furthermore, it is not offered to patients with interlobar collateral ventilation because of the lack of clinical efficacy. We describe two novel management approaches including (1) bilateral bronchoscopic lung volume reduction, and (2) a combined thoracic surgical and interventional pulmonary procedure involving surgical fissure completion followed by endobronchial valve placement, which culminated in safe and effective lung volume reduction of both lungs along with an excellent patient outcome.