Song et al retrospectively reviewed 461 cases of IPF (269 biopsy-proven) in Korea. More than a third of patients were hospitalized for respiratory deteriorations over a 2-year period. About half the deteriorations were attributed to acute exacerbations of IPF, with most of the rest attributed to infections (half the patients had BAL and/or ET aspirates as part of a separate study protocol). In news reports, this is being spun as a surprisingly low number of viral infections causing exacerbations, contradicting dogma. Half of those admitted died in-hospital; 90% of those requiring mechanical ventilation died. ERJ 2011;37:356-363.