Review Question - QID 212691

A 56-year-old woman comes to the clinic for a post-operative follow up appointment. She underwent a liver transplant 3 months ago for cirrhosis secondary to autoimmune hepatitis. The patient is complaining of nausea, abdominal cramps, and diarrhea for the past 2 weeks. She denies vision changes, chest pain, vomiting, or urinary symptoms. When asked if anything could have brought on the symptoms, she reports that she was stung by a bee 1 week ago. She is currently taking tacrolimus and mycophenolate. A physical examination demonstrates overactive bowel sounds, abdominal tenderness especially at the right upper quadrant, and a rash shown in Figure A. What is the most likely explanation for this patient’s symptoms?