{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:28:59Z","timestamp":1786559339069,"version":"build-2736575974"},"reference-count":5,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There have been no previously reported cases of pulmonary alveolar proteinosis (PAP) complicated by invasive pneumococcal infection requiring veno\u2010venous extracorporeal membrane oxygenation (V\u2010V ECMO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 44\u2010year\u2010old man was transferred to our hospital under V\u2010V ECMO for severe respiratory failure. Chest computed tomography showed bilateral crazy\u2010paving patterns, and milky bronchoalveolar lavage fluid confirmed PAP. On day 3, he developed septic shock due to\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      . After stabilization, right\u2010sided whole lung lavage was performed on day 7, yielding yellow\u2010brown fluid atypical for PAP. Bilateral segmental lavages on days 12 and 13 improved oxygenation. ECMO was discontinued on day 10, and the patient was extubated on day 14.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this rare case of PAP complicated by invasive pneumococcal infection, timely therapeutic interventions were successfully performed under V\u2010V ECMO support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ams2.70110","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:30:52Z","timestamp":1766727052000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Alveolar Proteinosis Complicated by Invasive\n                    <scp>\n                      <i>Streptococcus pneumoniae<\/i>\n                    <\/scp>\n                    Infection Requiring Extracorporeal Membrane Oxygenation: A Case Report"],"prefix":"10.1002","volume":"13","author":[{"given":"Utaho","family":"Mizusawa","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Ohshimo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3159-0333","authenticated-orcid":false,"given":"Kazuya","family":"Kikutani","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momoko","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2342-7245","authenticated-orcid":false,"given":"Mitsuaki","family":"Nishikimi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Namba","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Masuka","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Inagawa","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Shime","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13831"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.894644"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-016-0497-9"},{"issue":"1","key":"e_1_2_10_5_1","first-page":"9","article-title":"Whole\u2010Lung Lavage for Severe Pulmonary Alveolar Proteinosis Assisted by Veno\u2010Venous Extracorporeal Membrane Oxygenation: A Case Report","volume":"55","author":"Jo\u00e3o P. M.","year":"2018","journal-title":"Canadian Journal of Respiratory Therapy: CJRT = Revue Canadienne de la Th\u00e9rapie Respiratoire: RCTR"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.56.6920"}],"container-title":["Acute Medicine &amp; Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.70110","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ams2.70110","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.70110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T17:42:22Z","timestamp":1786556542000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ams2.70110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,25]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ams2.70110"],"URL":"https:\/\/doi.org\/10.1002\/ams2.70110","archive":["Portico"],"relation":{},"ISSN":["2052-8817","2052-8817"],"issn-type":[{"value":"2052-8817","type":"print"},{"value":"2052-8817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,25]]},"assertion":[{"value":"2025-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70110"}}