A 73-year-old woman on hemodialysis for end-stage renal disease was admitted to our institution from a subacute-rehabilitation facility due to a fever of 102°F. The patient reported some nausea, diarrhea, abdominal pain, and weakness but stated that she had been experiencing these symptoms for some time. Other than the above-mentioned gastrointestinal symptoms, the patient denied any cardiopulmonary, upper respiratory, or genitourinary symptoms. No contaminated food items were identified, and no other residents at the facility were presenting with similar symptoms. Physical examination revealed a diffusely tender abdomen without evidence of any other systemic signs. A computed tomography (CT) examination of the abdomen demonstrated possible right-sided colitis, and the patient was begun on ciprofloxacin and metronidazole. Initial blood cultures (Bactec; Becton, Dickinson and Company) collected in the emergency room demonstrated no growth; however, blood cultures collected the following day, as the patient underwent hemodialysis, grew Gram-positive bacilli. Initial Gram stainings performed directly from the aerobic and anaerobic blood culture bottles demonstrated long, chaining, Gram-positive bacilli (Fig. 1). The morphology of the Gram-positive rods was suggestive of lactobacilli. The blood culture plates demonstrated pure growth of small, pale-appearing colonies. The colonies were found to be Gram-positive coccobacilli which were catalase positive and oxidase negative. A definitive identification was made from the primary culture plates. Fig 1 Gram stain of bacilli from a blood culture bottle. (For answer and discussion, see page 1655 in this issue [doi:10.1128/JCM.01126-12].)