Acute respiratory distress syndrome (ARDS) is a clinical and pathophysiologic entity characterized by an acute and diffuse injury of the endothelial and epithelial surfaces of the lung, leading to respiratory failure. During the late phase of ARDS, glucocorticoids could have a beneficial effect on lung fibroproliferation but predispose to the development of pneumonia and sepsis. Alterations in cellular immunity observed in intensive care unit patients facilitate the progression from Candida colonization to Candida infection. However, in these critically ill patients, it remains difficult to distinguish colonization from invasive infection. As illustrated by this case report of a late ARDS successfully treated by glucocorticoids, the presence of Candida in bronchoalveolar lavage of ARDS in non-neutropenic patients should be considered with care before interpreting it as a colonization of the airways.
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