A 59-year-old woman was admitted to our institution with worsening shortness of breath and fatigue. Eight months earlier, she had received a living donor kidney transplant. She had been doing well on immunosuppressants, which were azathioprine, sirolimus, prednisone, and sulfamethoxazole-trimethoprim; sirolimus was started 2 months prior to her current admission. Two weeks before this presentation, the patient was admitted for similar complaints with fever, and her condition was diagnosed as pneumonia and urinary tract infection complicated by gram-negative bacteremia. Subsequently, she was given meropenem and discharged with a 21-day prescription. Two weeks later, she presented to the transplant clinic with worsening fatigue and shortness of breath and was admitted. The patient’s medical history was significant for hypertension, hyperlipidemia, and end-stage renal disease secondary to hemolytic uremic syndrome. She was a nonsmoker and denied a history of contact with sick persons, pets, or travel. There was no family history of malignancy.