Case Presentation: 18-year-old female presented with one week of fever, left flank pain, and sore throat. On arrival she was febrile, tachycardic, hypotensive, and tachypneic. Physical exam was notable for left flank tenderness, labial and buccal ulcerations. Labs were significant for positive urinalysis, leukocytosis, blood cultures with gram negative bacteria, and recent negative streptococcus rapid [...]