The patient was a 15-year-old girl who presented with terminal respiratory insufficiency secondary to cystic fibrosis. She was otherwise stable with no other significant active medical and surgical problems. On August 20, 1999, the patient underwent bilateral lung transplantation. The time of total ischemia of the graft was 7 h and 30 min. Medical treatment involved use of cyclosporine, azathioprine, and methylprednisolone, combined with empirical anti-infectious agents (IV ganciclovir and amphotericin B). The immediate postoperative period was significant for septicemia due to Alcaligenes xylosoxidans, which resolved with therapy with ceftazidime, tobramycin, and ciprofloxacin. Endobronchial Aspergillus colonization, for which therapy with inhaled amphotericin B was added, occurred mainly on the right bronchial suture and was found on the ninth day after the transplantation. The patient was weaned from mechanical ventilation and extubated on day 13.