Review Question - QID 208569

A 32-year-old female with no past medical history presents to the emergency department with complaints of fever, malaise, myalgias, abdominal pain, and vomiting. The patient's vital signs are: temperature is 102.2°F (39.0°C), blood pressure is 118/92 mmHg, pulse is 90/min, and respirations are 15/min. On physical exam, she is noted to be diaphoretic. She reports travel to Ghana several months ago as well as more recent travel to Wisconsin and Mexico. Upon further questioning, she notes that she camped overnight outside while in Wisconsin, and she swam in freshwater lakes and walked barefoot on the beach while in Mexico. She has noticed that her symptoms seem to be worse every other day. She is sexually active and has exposure to two sick contacts at home. Laboratory testing reveals the following:
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