Imaging characteristics from lung CT. A 46-year-old woman was admitted to the ICU for acute respiratory failure. She underwent kidney transplantation 12 years ago. She reported fever and a typical chickenpox skin rash 5 days before admission. The onset of respiratory symptoms started 2 days before ICU admission and invasive mechanical ventilation was implemented at day 1. She developed a severe ARDS requiring prone positioning, neuromuscular blockers, and 14 days of invasive mechanical ventilation. Lung CT scan demonstrated diffuse bilateral nodules, patchy ground glass opacities, and interlobular septal thickening. A fiber bronchoscopy with bronchoalveolar lavage documented a Staphylococcus aureus co-infection. She received intravenous aciclovir 10 mg/kg/8 h during 15 days associated with 10 days of oxacilline and was discharge alive from the ICU 17 days after admission