A 72-year-old man who underwent bilateral orthotropic lung transplantation for interstitial lung disease 6 months ago presented to the clinic with a 2-week history of cough, shortness of breath, and mid-back pain. The donor was negative for cytomegalovirus (CMV) and positive for Epstein-Barr virus (EBV), and the recipient was positive for both CMV and EBV. He also reported headaches but denied any fever, chills, weight loss, night sweats, chest pain, orthopnea, paroxysmal nocturnal dyspnea, or leg swelling. His other medical history included renal cell carcinoma, for which he had undergone partial right nephrectomy 6 years earlier. The patient lived in central Florida and denied any recent travel to the fungal endemic areas or international travel. He never suffered from TB or had any exposure to patients with TB. His immunosuppressive regimen consisted of tacrolimus, mycophenolate mofetil, and prednisone. The targeted tacrolimus trough level was 10 to 12 ng/mL, and the patient was generally in the therapeutic range.

中文翻译：

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一名 72 岁男性，肺移植术后出现无数双侧肺结节。


一名 72 岁男性，6 个月前因间质性肺病行双侧正交各向异性肺移植手术，因咳嗽、呼吸短促和中背部疼痛 2 周就诊。供者巨细胞病毒 （CMV） 阴性，EB 病毒 （EBV） 阳性，受者 CMV 和 EBV 均阳性。他还报告了头痛，但否认有任何发热、寒战、体重减轻、盗汗、胸痛、端坐呼吸、阵发性夜间呼吸困难或腿部肿胀。他的其他病史包括肾细胞癌，为此他 6 年前接受了部分右侧肾切除术。该患者住在佛罗里达州中部，否认最近曾前往真菌流行地区或进行过国际旅行。他从未患过结核病，也从未接触过结核病患者。他的免疫抑制方案包括他克莫司、吗替麦考酚酯和泼尼松。目标他克莫司谷水平为 10 至 12 ng/mL，患者总体在治疗范围内。