Cytokine Storm Following Lung Transplant in the Setting of Alistipes finegoldii Bacteremia: A Case Report

Cytokine storm is an uncommon but devastating complication following lung transplantation, characterized by systemic hyperinflammation, multiorgan dysfunction, and hemodynamic collapse. We report the case of a 36-year-old woman with systemic sclerosis-associated interstitial lung disease and pulmonary arterial hypertension who underwent bilateral lung transplantation and developed severe primary graft dysfunction requiring extracorporeal membrane oxygenation. Her course was complicated by clinical and biochemical features consistent with a cytokine storm, including elevated ferritin, IL-6, creatine phosphokinase, and transaminases, as well as persistent fever, rash, myocarditis, and vasoplegic shock. Despite aggressive immunomodulatory therapy—including corticosteroids, intravenous immunoglobulin, plasmapheresis, and anakinra—her recovery was protracted and complex. This case highlights the need for early recognition of cytokine storm in the lung transplant population and supports incorporating cytokine-targeted strategies into the management of severe posttransplant inflammation.