ArticleInfection and drug resistance2026
Timing of Whole Lung Lavage in Autoimmune Pulmonary Alveolar Proteinosis with Concurrent Opportunistic Infection: A Case Report and Systematic Review.
Article in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare lung disorder characterized by abnormal accumulation of surfactant in the alveoli, often leading to progressive respiratory failure. While whole lung lavage (WLL) remains the standard therapeutic intervention, its timing and safety in the context of active infection remain a critical clinical dilemma. Case Presentation: We present a fatal case of a 42-year-old Tibetan female with aPAP and progressive respiratory failure requiring V-V ECMO. Critically, serological tests were negative, but targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid revealed a dominant mixed opportunistic infection ( Conclusion: This fatal aPAP case suggests a staged management approach whereby WLL should be deferred until infection control is achieved. Early tNGS-guided pathogen identification appears crucial for directing antimicrobial therapy. This target-then-lavage strategy merits further validation but offers a prudent framework for managing these high-risk patients.
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