November-December 2017, Volume 14, Issue 6
A Man With Fevers, Headaches and Hemolytic Anemia
Published on: October 28, 2017
A 65-year-old man with no significant medical history presented with one week of recurrent fevers, chills, and severe headaches. He had recently returned from a summer trip to Maine and New York where he hiked in wooded areas and sustained multiple mosquito and tick bites. A lumbar puncture showed no evidence of meningitis. Laboratory examinations were notable for a Coombs-negative hemolytic anemia, thrombocytopenia, and mildly elevated transaminases. The peripheral blood smear is shown below.