A 19-year-old Hispanic woman with an intrauterine pregnancy at 37 weeks was admitted to the labor and delivery department for tachycardia and signs of oligohydramnios. On admission, she complained of chest pain, sore throat, and dry cough of 3 weeks in duration, and fevers and dyspnea for the last 3 days. She denied photophobia, sputum production, nausea or vomiting, rigors, or night sweats, but noted a painless skin lesion on her right upper forearm for at least several weeks. She was otherwise a healthy woman originally from Mexico, with no previous medical or surgical problems. At the time of hospital admission, she was a housewife residing in central California with her husband. There was no history of sick contacts, recent travel, exposure to birds, or illicit drug use.