Abstract
A previously healthy 31-year-old man without a history of cardiac disease presented to the emergency department with a 5-day history of a sore throat, neck stiffness, progressive dyspnea, transient confusion, fever, palpitations, and a generalized rash. His medical history was unremarkable. He reported no recent local or foreign travel, sick contacts, vaccinations, new medications, or exposure to human immunodeficiency virus or hepatitis. He had not been on any recent camping trips and had had no tick or rodent exposure. Of note, he lived in northwestern Wisconsin.
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