A 2-year-old male presented to our emergency department with lethargy, increased work of breathing, and abdominal pain of 1-day duration. Two weeks prior to presentation, his primary care physician clinically diagnosed him with pneumonia when he presented with high fever, runny nose, and eye drainage. No chest radiograph was done at this time. There were also sick family members with similar symptoms. He received 5 days of azithromycin. He took longer to recover than the rest of his family, but was close to normal activity in 10 days. Four days prior to admission, he seemed to relapse when his mother noticed his chest “caving in” and she could “see his heart beating hard and fast.” He also had decreased oral intake and no urine output during the 12 hours prior to admission. During the day of admission, his legs began to swell, and he appeared to have swelling throughout his body. There had been no associated fever, nausea, vomiting, diarrhea, or rash. He had no significant past medical history.