received vaccine 1/27, developed fevers that night. she continued to have fever, also had chills, headache, body aches. developed abdominal distension. presented to ed on 1/31/2022. found to have fever, tachycardia, tachypnea, leukocytosis, elevated lactate and abnormal lfts. she was admitted to the icu, started on antibiotics for presumed sepsis. initial suspicion of cholecystitis, went for cholecystectomy and no cholecystitis but liver was inflamed, had biopsy. subsequently, developed acute hypoxic respiratory failure with ct showing new pulmonary infiltrates. bronchoscopy done and suggestive of diffuse alveolar hemorrhage, bronch studies pending but so far infectious work up negative. she also developed elevated troponin with normal echo. she developed anemia, required transfusion. she is currently intubated and remains in the icu with ongoing fevers