Question: A 49-year-old Caucasian man with a past medical history of hyperlipidemia presented with colicky, generalized abdominal pain of 3 weeks’ duration. He had traveled to Mexico 3 months prior; however, he denied sick contacts or antibiotic usage, ingested bottled water exclusively, and adhered to a vegan diet. Three days before presentation, he developed a bilateral lower extremity purpuric rash (Figure A) and intermittent melenic stool. Upon presentation, he was noted to have a leukocytosis of 30,300/mm3, creatinine of 0.8 mg/dL, hemoglobin of 15.7 g/dL, platelets of 287,000/mm3, and an International Normalized Ratio of 1.2.