Conclusions
Acute diffuse parenchymal lung disease can have many causes. While
primary immunodeficiencies are rare, they should be part of the
differential diagnosis in all atypical or complicated cases, even in
previously healthy children. Our patient with CGD probably suffered from
inflammatory lung involvement, caused by exposure to fungi with possible
mycotic colonization and subsequent CMV reactivation. Although systemic
corticosteroid therapy is the first choice in the treatment of
hypersensitivity pneumonitis, it may represent a risk for children with
compromised immune functions, which should be, in selected cases,
assessed prior to the immunosuppressive treatment.
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