Joey is a 53-year-old man from North Carolina. Joey is a smoker and had recently returned from a relaxing weekend at a spa in the mountains. The hot tub and sauna were very relaxing. He came to the emergency department because he had shortness of breath, fatigue, a cough, diarrhea, and arthralgias. He described the fatigue as overwhelming. The cough was nonproductive. One day before admission, he had had fever and chills, with a maximum body temperature of 38.6°C (101.4°F). Watery, brown diarrhea occurred without other gastrointestinal distress and was intermittent, approximately 7 to 8 times a day. Chest sounds revealed a crackling sound, and a chest x-ray suggested possible pneumonia.