A 50-year-old woman was hospitalized with a 2-week history of nausea, vomiting, diarrhea, epigastric abdominal pain, hematuria, and a skin rash. Prior to hospitalization, the patient was administered ciprofloxacin for a urinary tract infection and, subsequently, metronidazole for presumed Clostridium dificile colitis. The patient recently returned from a camping trip to southwestern Missouri. Her medical history was significant for a cadaveric renal transplant approximately 3 months prior for end-stage renal disease secondary to adult polycystic kidney disease. Her immunosuppressive regimen consisted of prednisone, tacrolimus, and mycophenolate mofetil.