Introduction
Acute onset dyspnea with the clinical picture of pneumonia, often associated with respiratory insufficiency, is a relatively common clinical presentation in childhood. Most such cases are caused by an infection of an otherwise healthy respiratory system, and usually, such patients respond well to standard therapy with antibiotics and corticosteroids. However, this clinical presentation can also be a secondary complication of an underlying chronic diseases, such as bronchial asthma, cystic fibrosis, primary ciliary dyskinesis or immunodeficiency, some of which may represent a diagnostic conundrum.