A crazy cause of dyspnoea: pulmonary alveolar proteinosis.

In March 2012, a 37-year female patient presented to the emergency department with a 6 months history of progressive dyspnoea, fatigue, insomnia and generalized body pains. There was no accompanying cough or haemoptysis. She was a non-smoker with no background medical or surgical history. No risk factors for pulmonary disease could be identified from her occupational history. Prior to her admission she was treated with multiple courses of empirical antibiotics and bronchodilators without complete resolution of her symptoms.