A 73-year-old woman was admitted to the intensive care unit (ICU) with acute respiratory distress. She was a lifelong non-smoker living with her husband in a rural area, and had a medical history of hypertension and type II diabetes. The day prior to admission she fell ill with malaise and fever. Nausea, vomiting and pronounced shortness of breath ensued. The initial findings at admission included fever, tachycardia, tachypnoea, hypoxia and somnolence. Laboratory findings during hospitalisation indicated coagulopathy, elevated levels of lactate dehydrogenase (LDH), and development of renal failure (Table 1 ). There was release of cardiac enzyme troponin T (peak value 1.6; normal value <0.01 μg/L), indicating myocardial tissue damage.