Case Presentation A 17-year-old girl received lung transplantation after chronic respiratory
failure. She developed a fever (> 38° C) once or twice weekly starting 2 months after
surgery, and multiple papulopustules on the skin waxed and waned for 4 months. She then
developed blood-tinged sputum. She had been treated with triple immunosuppressants,
including prednisolone, tacrolimus, and mycophenolate mofetil after lung transplantation,
and her symptoms appeared during prednisolone dose reduction.