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B. hermsii blood CDC Bacterial Diseases Branch, Fort Collins, Colorado

Case Study 7
A 60-year-old male from Boise, Idaho had a 1 month history of intermittent fevers and headache. He reported a fever of 105º F with a headache for 3 days. A second fever presented 13 days later that lasted 2 days. He finally sought medical attention when he had his third fever 26 days after the first symptoms. His history was remarkable for having camped in a cabin in the Bear Valley region of Idaho.
Laboratory values were:
  • CBC: Normal with 81% segmented neutrophils, 6% lymphocytes, and 3.37% reticulocytes
  • Urinalysis: Normal except for a 1+ protein
  • Bilirubin: Increased
Diagnosis was made on the Giemsa-stained blood smear shown in the image. What is the most likely diagnosis of this man?

Please select the single best answer