A 42-year-old man presented with a several-day history of fever (40°C [104°F]), pneumonia, and an eruption on the forehead, scalp, arms, and trunk. He was initially diagnosed with varicella and was started on acyclovir treatment. However, owing to worsening dyspnea, he was evaluated in the emergency department and admitted for hypotension (blood pressure, 89/60 mm Hg; heart rate, 116 bpm) requiring treatment with vasopressors and intubation for respiratory distress. He was otherwise healthy and taking no medications.