Immunosuppressive treatment was used empirically and because of the presence of neutrophils and some lymphocytes in the lavage specimens and in the interstitial space of the lung biopsy sample of the patient ( Figure 2B ). Unfortunately severe and prolonged infections occurred, including a cavity forming infection with Aspergillus fumigatus which was treated by i.v. and inhaled amphotericin B and surgical resection of the cavity. Sustained withdrawal of the systemic corticosteroids from age 8 years onward did not alter the activity of the underlying PAP, but reduced the rate of infectious respiratory complications considerably.