CASE PRESENTATION: 82-year-old male presented with rapidly progressing severe low back pain without weakness, numbness or loss of bowel or bladder function. On presentation, he was afebrile and hemodynamically stable. MRI lumbar spine was suggestive of metastatic disease and CT abdomen revealed a right renal mass with suspected metastasis to the liver and adrenal glands. A percutaneous biopsy of the right renal mass revealed renal cell carcinoma on pathology. However, six days after biopsy, patient developed hypotension and respiratory distress requiring mechanical ventilation and vasopressors. He was empirically started on intravenous meropenem and vancomycin for presumed septic shock. Intravenous fluconazole was initiated after blood cultures resulted in growth of C.lusitaniae. It was later switched to caspofungin due to worsening transaminitis. Patient’s hemodynamic status improved with discontinuation of vasopressors on day 5 of antifungal treatment and repeat blood cultures resulted negative.