On May 2, 2011, a previously healthy woman aged 24 years sought treatment at a local emergency department in Colorado after 1 week of fever, nausea, headache, stiff neck, and occasional blurred vision. Approximately 20 hours earlier, she had delivered a newborn (at 39 weeks' gestation) in a mountain cabin, without medical attendance. She had received limited prenatal care. Delivery was notable for amniotic fluid discoloration consistent with meconium. Physical examination revealed an ill-appearing and afebrile woman with hypotension (blood pressure: 70/40 mmHg). Gynecologic examination was unremarkable. A complete blood count revealed an elevated white blood cell count of 18,000/μL (normal: 4,500-10,000/μL), a decreased hematocrit of 30% (normal: 37%-47%), and a decreased platelet count of 42,000/μL (normal: 130,000-400,000/μL). Blood chemistries were remarkable for an elevated creatinine of 1.6 mg/dL (normal: 0.6-1.3 mg/dL), elevated aspartate aminotransferase of 61 IU/L (normal: 15-37 IU/L), and elevated alkaline phosphatase of 422 IU/L (normal: 50-136 IU/L). She was admitted and treated empirically using intravenous piperacillin with tazobactam for postpartum sepsis and fluid resuscitation for hypotension. Antibiotics were changed to oral amoxicillin after 48 hours. A blood culture drawn at admission revealed no growth, and the patient remained afebrile during hospitalization. Because of worsening anemia, she was transfused with packed red blood cells on May 3. Her condition improved, and she was discharged on May 5.