THE CAUSE of the adult respiratory distress syndrome (ARDS) remains unknown, but a variety of clinical entities are associated with it. Usually, only supportive treatment is recommended, with prevention of tissue hypoxia the primary goal, but it is important to be aware of all specific diseases that may lead to ARDS so that therapy can be individualized rather than just supportive. Report of a Case A 34-year-old woman was admitted to Tampa (Fla) General Hospital in August 1978 with a five-day history of nausea, intermittent fever, and vaginal bleeding. She was taking no medications and her only previous hospitalizations were for uncomplicated childbirth. Physical examination revealed an obese, afebrile woman with a respiratory rate of 14/min. She was confused and uncooperative. Her fundi were normal, and her conjunctiva were pale and icteric. The neck was supple. Examination of the heart and lungs showed normal findings. Vaginal wall petechiae were seen,