[Chronic septic granulomatosis imitating exogenic allergic alveolitis (farmer's lung)].

A 17-year-old boy demonstrated clinical and immunological signs of exogenic allergic alveolitis (farmer's lung). The patient grew up in the country and suffered from recurrent "pneumonia." In his serum precipitins were detected against Micropolyspora faeni, Aspergillus fumigatus and hay. Transbronchially obtained lung tissue showed histologically an inflammation of the epitheloid-cell-granulomatous type with fibrosis. A congenital defect of the neutrophilic function was suspected in view of the recurrent infections with significant polyclonal hypergammaglobulinemia, accompanied by leucocytosis and neutrophilia. In vitro studies of isolated patient's neutrophils showed that he suffered from chronic granulomatous disease. CGD should be considered in adolescents and adults with a history of severe infections and unexplained pulmonary fibrosis or pulmonary fibrosis simulating exogen allergic alveolitis.