On August 23, 2010, CDC was notified regarding two organ transplant recipients in Arizona who had encephalitis with multiple ring-enhancing lesions revealed by cerebral magnetic resonance imaging. The common organ donor, a Hispanic male landscaper aged 27 years, had died in Arizona from a presumed stroke on July 21. He had a large skin lesion for approximately 6 months on his back that he had attributed to an insect bite. The ill recipients, a male liver recipient aged 56 years, and a male recipient of a kidney and pancreas aged 24 years, received organ transplants on July 22. In addition, two other recipients received organs from this donor: an adult male heart recipient received his transplant in California on July 22, and an adult male kidney recipient received his transplant in Utah on July 23.