Figure 5

Clinical complication. At age 5 years a chest CT (Figure. 5 A) showed a cavity and infiltration in the left lower lobe which was due to an infection with Aspergillus fumigatus; the resected specimen showed an aspergilloma (black arrows) in the neighborhood of typical alveolar proteinosis with surfactant filled alveoli (white arrows)(Figure. 5 D). Inside the cavity a neutrophilic infiltrate (Figure. 5 B) and infection with aspergillus (Figure. 5 C, almost all fungi, arrows indicate neutrophils) was present.