A 64-year-old man who was human immunodeficiency virus (HIV)-positive presented to the ER with a 4-day history of headache and malaise. On interrogation, he referred traveling to the United States during the previous 2 weeks. Baseline characteristics are shown in Table 1. On admittance, he had a temperature of 38.3 °C. On his seventh day of hospital stay, he developed respiratory insufficiency and was intubated. Septic shock was diagnosed on the eighth day and vasopressor support was initiated. A TTE was done to evaluate shock etiology, which showed an abnormal ventricular geometry with concentric remodeling and a GLS of -18% with an LVEF of 66% (Table 2). During his time in the ICU, on day 14, the subject developed new infiltrates on his chest X-ray, so a diagnosis of ventilator-associated pneumonia was entertained, and broad-spectrum antibiotics were started. This was eventually found to be caused by Klebsiella spp, according to an endotracheal aspiration culture. On his 21st day, he presented massive hemoptysis and expired.