DOI: https://doi.org/10.36347/sjmcr.2026.v14i11.019

Pages: 2483-2486

Pulmonary alveolar proteinosis (PAP) is a rare disease caused by the intra-alveolar accumulation of lipoproteinaceous material resulting from impaired surfactant clearance. It mainly affects young adults and often presents with progressively worsening dyspnea, sometimes contrasting with severe hypoxemia. We report the case of a 32-year-old man with no medical history, admitted for progressively worsening respiratory distress over 3 months, in an afebrile context. On admission, he was conscious and tachypneic at 38 breaths/min, with an oxygen saturation of 60% on room air, corrected to 97% with 6 liters of oxygen, intercostal retraction, and hemodynamic stability. Chest radiography showed symmetrical bilateral opacities, and chest computed tomography showed diffuse ground-glass opacities without associated cardiac signs, suggesting PAP. Bronchoalveolar lavage (BAL) returned a milky fluid, confirming the diagnosis of idiopathic PAP. The course after whole-lung lavage was favorable, with marked clinical improvement within 3 days. PAP should be considered in the presence of progressive dyspnea associated with diffuse ground-glass opacities in the absence of a cardiac cause. BAL guides the diagnosis, and whole-lung lavage remains the reference treatment, allowing rapid improvement.