A 36-year-old female patient presented with high-grade fever for 10 days followed by pedal edema and decreased urine output for 4 days. She developed shortness of breath for the last 3 days, which was associated with a dry cough. There was no history of paroxysmal nocturnal dyspnea and orthopnea. The history of epistaxis was present for 1 day. No history of travel to another place was present. On examination, she was conscious and well oriented. Her pulse rate was 124/min, blood pressure was 90/60 mmHg, and SpO2 was 86% on room air. Eschar was present under the left breast. On auscultation, bilateral crepitations were present. A cardiovascular examination revealed no abnormality. Blood investigations revealed hemoglobin–9.0 mg/dL, platelet count–70,000/mm3, blood urea–108 mg/dL, serum creatinine–1.6 mg/dL, blood sugar–91 mg/dL, SGOT/PT–440/235. The chest X-ray was suggestive of bilateral diffuse alveolar shadows. Arterial blood gas analysis revealed pH–7.38, pO2–58 mmHg, pCO2–44 mmHg, HCO3–15 mmol/L, and SaO2–86%.