The chest x-ray shows a patient who had a left lung transplanted in May 2003 for cryptogenic fibrosing alveolitis, which was diagnosed post-transplant as sarcoidosis.
<p>The donor was CMV negative, the recipient CMV positive and the ischaemic time of the transplanted lung was 5 hours. Bronchoscopy a week post-transplant revealed no evidence of airway narrowing. However, he developed an area of necrotic tissue and sputum plugging partially obstructed the left main bronchus over the next couple of month's which were managed bronchoscopically without evidence of infection. There was also some evidence of narrowing of the airways, which required insertion of a bronchial stent three months post transplant. Three months following this, the stent was in a good position but there was a considerable amount of mucus and pus around the stent, which was removed bronchoscopically. This grew Aspergillus fumigatus. He was treated with itraconazole with the stent remaining in situ.</p>