Case Presentation: A 56-year-old man with a history of ulcerative colitis (UC), treated with Adalimumab, returned from a 10-day cruise to Puerto Rico. He presented with 5-days of fever, chills, fatigue, anorexia and multiple loose stools daily. On presentation, he was ill-appearing, febrile (T = 102.8oF) and tachycardic (HR = 124 bpm). RR = 16 [...]