A 48-year-old woman presented to the emergency department complaining of fever, severe right-sided chest pain, and dehydration. A week earlier, fever to 102°F, upper respiratory tract symptoms, nausea, vomiting, diarrhea, and decreased oral intake had developed. On the day before hospital admission, she developed severe right-sided chest pain, nonproductive cough, and slurred speech. Her medical history was notable for life-threatening “scarlet fever” as a child. She smoked cigarettes and drank alcohol occasionally but not to intoxication.