• Udit Chaddha, Pradnya D Patil, Ashraf Omar, Rajat Walia, and Tanmay S Panchabhai.
• Department of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA.
• Chest. 2018 Jun 1; 153 (6): e147-e152.

Case PresentationA 47-year-old man who was a redo double lung transplant recipient (cytomegalovirus [CMV] status: donor positive/recipient positive; Epstein-Barr virus status: donor positive/recipient positive) presented to the hospital with 1 week of generalized malaise, low-grade fevers, and dry cough. His redo lung transplantation was necessitated by bronchiolitis obliterans syndrome, and his previous lung transplantation 5 years earlier was for silicosis-related progressive massive fibrosis. He denied any difficulty breathing or chest pain. There was no history of GI or urinary symptoms, and the patient had no anorexia, weight loss, night sweats, sick contacts, or history of travel. He had a history of 1 earlier episode of CMV viremia that was treated with valganciclovir. His immunosuppressive regimen included tacrolimus, mycophenolate mofetil, and prednisone, and his infection prophylaxis included trimethoprim-sulfamethoxazole, itraconazole, and valganciclovir. Results of a chest radiograph 8 weeks earlier were normal.Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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