Although I am not supposed to have a favorite patient, she is one. Arissa is a three-year-old girl. Her parents, natives of Comoros, had illegally immigrated to the French department of Mayotte. When she was two months old, Arissa developed shortness of breath and a febrile diarrhea associated with an enlarged liver and spleen. Her first diagnosis was a cy-tomegalovirus infection, but the symptoms persisted despite treatment, and she was transferred to Paris, while her parents remained in hiding in Mayotte. Finally, pulmonary alveolar proteino-sis was diagnosed when she was ten months old.
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