Abstract
Surfactant deficiency is a rare genetic disease. Clinical presentation is manifested with a large specter that varies from severe form to lethal in neonatal age and to progressive, chronic form of the interstitial lung disease in older child. In this manuscript we want to present the case of a two years and 7-month-old child, which was diagnosed with Pediatric Acute Respiratory Distress Syndrome (PARDS) as consequence of bilateral interstitial pneumonia. The child was treated in a supportive way, placed in mechanical ventilation, antibiotic therapy and corticosteroid. After the complete examination, the child resulted with surfactant metabolism dysfunction of type ABCA3. In this case we want to emphasize the attention for rare genetic disease like surfactant deficiency as a cause of recurrent pneumonia cases with unclear focus.