We report the case of a 55-year-old female with a history of invasive urothelial carcinoma, hepatic and lymph node metastases, and prior radical cystectomy. The patient was admitted with a two-day history of fever, two weeks after undergoing percutaneous nephrostomy. Upon examination, she presented with hypotension, tachycardia, and abdominal pain. She was found to have severe lactic acidosis, acute renal failure, and a necrotizing soft-tissue infection confirmed via imaging. Blood cultures identified a multi-drug resistant