Therefore, it has been postulated that the pathogenesis of streptococcus viridans causing septic shock and/or ARDS is of host immune etiology.5,9,10,11,14,15 One study conducted in Germany, found much higher levels of IL-6 in 2 patients with lethal alpha-hemolytic streptococcus septic shock, than in controls with uncomplicated gram-positive bacteremia.15 Another study using enzyme-linked immunoabsorbent assays compared the ability of cell-free bacterial supernatants derived from commensal and clinical strains of viridans streptococci to induce pro-inflammatory cytokines. Here, IL6 is linked to acute respiratory distress syndrome.