A 65-year-old woman presented to the hospital with sepsis secondary to C. diff colitis in the setting of recent antibiotic use for a urinary tract infection. She was on adalimumab and methotrexate at home for history of rheumatoid arthritis. She was initially started on IV fluids, vancomycin, and metronidazole. Metronidazole was discontinued due to intractable nausea and vomiting. Infectious disease physician recommended treatment with 0.3 gm/kg one-time dose of IVIG. Three days later, neurology was consulted after she had witnessed generalized tonic-clonic seizures and became encephalopathic.  A CT brain showed new bilateral occipital and parietal juxtacortical and subcortical white matter hypodensities, which were not present on admission. MRI brain also showed generalized vasogenic edema in both occipital and parietal lobes consistent with PRES. She was treated with levetiracetam for her seizures. EEG revealed generalized slowing with sharp waves of epileptogenic potential in the left temporal region. Her encephalopathy improved with supportive treatment, and she was later discharged ten days after initial presentation.