This week’s case involves a 58-year-old patient who presented to the Emergency Department with a five-day history of worsening “flu-like” symptoms, including high fevers, drenching sweats, and significant fatigue. The patient is an avid hiker who recently returned to the UK following a three-week holiday in Nantucket, Massachusetts. They recall several insect bites during their trip but did not think much of them at the time.

Laboratory Results:

• Hb: 92 g/L
• PLT: 88 x10_⁹/L
• Bilirubin: Elevated (Unconjugated)
• LDH: Significantly raised
• Reticulocytes: Raised

Blood Film:

Given the patient’s travel history to the Northeast US, what do you think the diagnosis could be?

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