A 70-year-old man, who developed respiratory failure during antibiotic therapy for Staphylococcus aureus bacteremia, was diagnosed with acute respiratory distress syndrome. High-resolution CT at diagnosis showed bilateral diffuse reticulation with geographic appearance (black arrows), well-circumscribed infiltrations partially spared in secondary pulmonary lobule units, and bilateral pleural effusions. Although the patient was placed on mechanical ventilation in addition to being administered antibiotics, he passed away 4 days after diagnosis, and autopsy was performed. Pathological findings of the lungs revealed hyaline membrane formation along dilated alveolar ducts and alveoli, with shrinkage of adjacent alveoli and hyperplasia of type II pneumocytes, representing the exudate phase of diffuse alveolar damage