CASE PRESENTATION: A 37yo F with newly diagnosed acute myeloid leukemia underwent induction chemotherapy with Cytarabine and Daunorubicin, followed by Crenolanib, was hospitalized for 2nd induction with high dose Cytarabine, which was complicated by pancytopenia and typhlitis, which was treated with antibiotics. Within 48 hours of neutrophil recovery, she was re-hospitalized with fatigue, hypotension and fevers. CT chest on admission was normal. She remained intermittently febrile and developed a productive cough of yellow sputum. CXR on Hospital Day (HD) 3 showed new bilateral airspace opacities. Her labs were normal. She was started on antibiotics, and received fluid resuscitation. Her physical exam was remarkable for an O2 saturation of 92% on room air, a mild erythematous blanching rash on her extremities, crackles at the lung bases, and 1+ pitting edema of her lower extremities. Repeat CT chest on HD 5 showed widespread confluent consolidation in the mid to lower lung zones (Fig 1). TTE was normal. She underwent a diagnostic bronchoscopy with BAL on HD 6. Results from the lavage were unremarkable. Methylprednisolone 1mg/kg was started on HD 6, with significant improvement in her symptoms on HD 8. Her CXR demonstrated near complete resolution of the infiltrates (Fig 2). Steroids were discontinued and the patient was discharged on HD 9.