Pulmonary alveolar proteinosis is a rare disease. It is characterized by the accumulation of surfactants in the alveoli. Case presentation A 30-year-old male presented to the pulmonologist with a non-productive cough and progressively worsening dyspnea for over a year. The patient had lost over 10 kg over 12 months and had a high fever along with tremors and body aches. Social history: The patient worked at a sugar cane plantation. Past medical and medication history: The patient suffered from recurrent respiratory infections two years before the current presentation.

He was treated with numerous antibiotics for the same. Physical examination: The patient was observed to be cyanosed. A bilateral lung examination revealed coarse and fine rales. Chest CT: The scan revealed diffuse paving patterns. Cytological tests revealed the presence of increased lymphocytes and acellular proteinaceous…