A 51-year-old, previously healthy woman was transferred to our emergency department from an outside hospital with complaints of severe nausea and vomiting, diarrhea, and muscle cramps in her arms and legs that began several hours prior to presentation. Her medical history was significant for hypertension, dyslipidemia, and mitral valve prolapse. She underwent a splenectomy in 2004 secondary to trauma. She had received pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines after the splenectomy. She was a health-care worker and lived in a rural area with her husband where they managed livestock. She denied tobacco, alcohol, or drug use. She was allergic to penicillin and had an anaphylactic reaction in the past. She had received a dose of ciprofloxacin and metronidazole at an outside hospital after blood and urine specimens had been drawn.