A woman aged 25 years, with a history of blood transfusions in 2013 following extensive trauma from a train accident, and several recent hospitalizations for recurrent pneumonia and thrush, presented to the obstetrician for her initial first trimester prenatal visit. One week before presentation, she had been discharged from another hospital after a 2-week hospitalization for respiratory failure secondary to methicillin-resistant Staphylococcus aureus pneumonia. Imaging demonstrated bilateral pulmonary interstitial infiltrates, bilateral ground glass opacities, and pleural effusions. PCR testing was negative for a concomitant viral pneumonia. However, HIV testing had never been performed. The patient was discharged on amoxicillin and prednisone for pneumonia recovery. She was also prescribed fluconazole and clotrimazole for prior thrush. She was taking these medications at presentation.