Nocardia Bacteremia Associated With Pulmonary Alveolar Proteinosis

Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease, in which abnormal amounts of surfactant-rich material accumulate in the alveoli and interfere with gas exchange. Clinically, PAP is characterized by the insidious onset of exertional dyspnea and cough.(1) Less common symptoms include fatigue, weight loss, and fever, which typically occur if secondary infection is present.(1) With only approximately 400 cases reported in the literature since it was first described in 1958, PAP remains a rare cause of respiratory failure.(2)