Case presentation
A 24-year-old man consulted for cough and exertional shortness of breath. He had no particular past history other than smoking at 5 pack-years, weaned for 5 months. His illness began three years earlier by productive wet coughs with whitish sputum, sometimes abundant, which evolved in a context of impaired general condition with asthenia, anorexia, weight loss of 10 kilograms, and intermittent fever (not quantified). He has not had any previous investigations. On admission, the chest X-ray revealed bilateral, diffuse and polymorphic lung lesions (Figure 1).