Pulmonary Alveolar Proteinosis

A 22-month-old female child was referred with failure to gain weight, chronic cough and dyspnea. In physical examination she was under 5th percentile, had respiratory distress and crackles in chest auscultation. Chest roentgenography revealed alveolar infiltration in lungs. Sweat chloride test and standard work up for pulmonary tuberculosis were non-conclusive. Regarding X-ray findings suspicious of pulmonary alveolar proteinosis (PAP), right anterolateral thoracotomy was performed and lung tissue biopsy taken. Histopathologic findings were consistent with PAP which is a rare cause of chronic cough and dyspnea in children.