A 32-wk gestation female patient had Escherichia coli pneumonia, hyaline membranes, and pulmonary hemorrhage and died 20 h after birth. E. coli was cultured from the placenta and from both lungs at autopsy. In the lungs and other organs, bland segmental necrosis of the wall of small arteries and arterioles was observed. It was morphologically indistinguishable from that seen in naturally occurring and experimentally induced edema disease of swine, which suggests both conditions may share a common pathogenesis. In swine, the disease is caused by Shiga-like enterotoxin-producing E. coli. To our knowledge, this is the first documentation of edema disease-like arterial lesions in humans.