The authors describe a 10-year girl who was admitted and treated as sinusitis, then as a diarrhea with the use of antibiotics. The lasting high fever indicated possible meningitis, which was excluded after lumbar puncture. The clinical picture of the child deteriorated and there was additional tachycardia, tachypnea and cyanosis. The acute respiratory distress syndrome was diagnosed. The patient was transferred to the Intensive Care Unit, intubated and artificially ventilated. Lung biopsy was made and histology established a severe DAD (diffuse alveolar damage). Since the condition further deteriorated, hypoxemia became more severe as well as hypercapnia in spite of maximum ventilation parameters and 100% oxygen, the authors decided to treat the patient with pulse therapy with corticoids as well as immunosuppressive therapy with cyclophosphamide, which was administered for the period of three months. The condition gradually improved and HRTC finding of the lungs showed an unbelievable improvement. In view of the controversial opinions on the therapy with corticoids in available literature and no information about immunosuppressive therapy there is still open question what the twist of the disease caused.

        Key words: acute respiratory distress syndrome at the child age