A 57-year-old man was brought to our facility with complaints of chest and abdominal pain for 3 to 4 days. He was initially evaluated in the emergency department and found to be in mild distress secondary to the pain. His medical history was significant for hepatitis C, cirrhosis, coronary artery disease, and hypertension. His prior surgeries included three-vessel coronary artery bypass grafting and pacemaker insertion. The patient was hospitalized approximately 6 weeks earlier with an upper-GI bleed. Endoscopy performed at that time revealed a nonbleeding gastric ulcer as well as multiple gastric erosions and esophagitis. He received 2 U of packed RBCs. Serology results were positive for Helicobacter pylori, and the patient was discharged receiving metronidazole, clarithromycin, and pantoprazole. Review of systems on the current hospital admission was remarkable for fever, chills, dyspnea, anorexia, fatigue, and dark urine. He denied any travel outside of Texas in the past 5 years. He reported taking medications for BP and hyperlipidemia.