A 54-year-old woman presented to the ED complaining of dysuria. Following basic diagnostic testing, she received a diagnosis of cystitis and was discharged with ciprofloxacin. Urine cultures later grew pan-susceptible Escherichia coli. Three days later, she returned, complaining of progressively worsening shortness of breath and confusion. The patient’s medical history was significant for poorly controlled type 2 diabetes mellitus. She had no significant history of kidney disease prior to presentation.