We are presenting a rare case of pneumonia with acute respiratory distress syndrome (ARDS), septic shock, and cytokine storm by Kocuria kristinae. K. kristinae is usually a commensal, but it can be a pathogenic organism as well. We started teicoplanin as per the culture sensitivity report and continued for 10 days. We did ARDSnet protocol ventilation along with cytokine removal therapy as interleukin 6 (IL-6) level was very high (>5000) during and after cytokine removal therapy, oxygen, and vasopressors requirement reduced dramatically. The patient also developed subcutaneous emphysema, so the peep was reduced, which resolved conservatively. Over the period of time patient improved, was extubated, and discharged.
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