A 25-year-old African-American woman presented in the emergency room of a community hospital complaining of shortness of breath. The patient was admitted with a diagnosis of atypical pneumonia. Her respiration worsened despite intravenous erythromycin, nebulized albuterol, 40% oxygen via ventimask, and guaifenesin. An open lung biopsy revealed pulmonary tissue showing interstitial fibrosis with lymphocytes and histiocytes scattered within the fibrous tissue. Numerous alveoli contained mononuclear cells as seen in desquamative interstitial pneumonia. The patient did not respond to methylprednisolone and died on the eighteenth hospital day.