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A 58-year-old man presents to the ED with complaints of severe fever and chills, a diffuse headache, abdominal cramping, nausea and vomiting, and general weakness with lethargy. He returned from a lengthy business trip to Central America six days ago and has been experiencing such symptoms every three days. He notes that he had some generalized irregular fever while in Central America but did not seek help at that time. His blood pressure is 148/72 mm Hg, respiratory rate 24/min, heart rate 122 bpm, oxygen saturation of 96% on 2 L nasal cannula, and temperature 40.6°C. On exam, you note scleral icterus. Physical exam is unremarkable, with guaiac-negative stool. Lab results reveal a hemoglobin of 8 g/dL, platelets 175/µL, LDH 800 U/L, and indirect bilirubin 2.5 mg/dL. Which of the following is the most likely cause of this patient’s symptoms?ABabesiosisBChagas diseaseCDengue feverDMalaria

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