Michael Sperandeo

A 23-year-old male presents with generalized malaise and “no energy,” progressively getting worse over the last six weeks. He also reports non-productive, non-bloody cough, sore throat, and a diffuse, intermittent headache with non-bloody diarrhea. He has had subjective fever and chills for over a month. He is currently homeless as he recently emigrated from Southeast Asia. He has had multiple recent unprotected sexual encounters with both men and women and occasional IV recreational drug use. He does not take any medicines and has no medicine allergies but admittedly has not seen a doctor since arriving to America. On exam he is febrile and tachycardic. He appears cachectic and thin for body habitus. Initial blood work is significant for a WBC count of 120/mm3.