A 36-year-old woman presented to the emergency department with acute onset of fever, chills, and lethargy. She denied headache, cough, chest, or abdominal pain. She was the owner of a dog, but denied any dog bite. Her medical history included asthma and hypothyroidism. Her medications included albuterol/ipratropium and levothyroxine. There was no history of recent travel or sick contact.
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