A 61-year-old man with a history of hepatitis C infection and cirrhosis, type II diabetes mellitus, and coronary artery disease presented to the ED with a chief complaint of abdominal pain and hematuria. He reported a flu-like illness that had begun approximately 1 week prior to presentation. His symptoms included abdominal cramping, nausea, and diarrhea. On the day of presentation, hematuria and lethargy developed. There was no history of urinary problems, no unusual ingestions, and no family contacts with similar symptoms. In the ED, he was confused and complained of chest pain.