Review Question - QID 108808

A 68-year-old man presents to the emergency department with a chief complaint of cough and fever. The patient states that he has been feeling progressively worse for the past 2 days and decided to come into the emergency department because he felt short of breath and febrile. Prior to developing these symptoms, he was at a barbecue where he had an assortment of meats. He has a medical history of obesity, asthma, diabetes, and heart disease. He states that he had a recent surgery for his "heart problems." His current medications include albuterol, salmeterol, insulin, metformin, warfarin, aspirin, and ibuprofen. His temperature is 101°F (38.3°C), blood pressure is 131/92 mmHg, pulse is 91/min, and respirations are 18/min. A physical exam is significant for pulmonary crackles and a cardiac murmur. Laboratory results are shown:

Serum:
Na+: 139 mEq/L
Cl-: 100 mEq/L
K+: 4.7 mEq/L
HCO3-: 23 mEq/L
BUN: 20 mg/dL
Glucose: 145 mg/dL
Creatinine: 1.3 mg/dL
Ca2+: 10.1 mg/dL
AST: 11 U/L
ALT: 11 U/L

Hemoglobin: 11.1 g/dL
Hematocrit: 38%
Leukocyte count: 15,000/mm^3 with normal differential
Platelet count: 255,000/mm^3
INR: 2.9

A peripheral smear is ordered and is seen in Figure A. The patient is started on IV ceftriaxone. Which of the following best explains this patient's hematologic findings?