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A 34-year-old man came to the emergency room with a 3-day history of fevers (peak temperature, 40°C), accompanied by shaking chills. Laboratory tests revealed a hemolytic anemia, with a hemoglobin level of 8.6 g per deciliter. Nodular sclerosing Hodgkin's lymphoma, stage IIIB, had been diagnosed 12 years earlier, in 1994, and the patient underwent splenectomy at that time. He had traveled recently to Massachusetts, Oregon, Hawaii, Florida, and Illinois and to South Africa and Costa Rica. The peripheral-blood smear shows numerous intracellular organisms in red blood cells, with nearly 3% of erythrocytes harboring parasites. Multiple ring forms are seen, as . . . [Full Text of this Article] |