In our latest Case Challenge, a 59-year-old-man was admitted because of fever, confusion, rash, thrombocytopenia, and renal failure. He had been well until 3 days before admission, when flu-like symptoms developed while he was traveling. The patient’s hematocrit and white-cell count were normal, the platelet count was decreased, and the percentage of band forms was elevated. A chest radiograph was normal, but results of tests of renal and liver function were elevated, and testing for occult blood in the stool was positive. What is the most likely diagnosis?
Read the rest of the case and submit your diagnosis via our online poll. On Wednesday, February 12, results will be posted with the latest Case Record of the Massachusetts General Hospital on NEJM.org.