Successful Medical Management of Pulmonary Gangrene in a Transplanted Lung.

Pulmonary gangrene (PG) is a potentially devastating complication of necrotizing pneumonia. We describe successful nonsurgical management of PG in a lung transplant recipient. The patient presented with symptoms and imaging consistent with pneumonia. Bronchoalveolar lavage cultures demonstrated polymicrobial growth and antibiotic treatments were tailored. Imaging demonstrated a large cavitary lesion with intracavitary lung tissue consistent with PG. Prolonged antibiotic therapy resulted in clinical improvement and radiographic resolution.