Review Question - QID 213694

A 37-year-old man presents with a fever and malaise that has been worsening over the past 3 days. The patient states that he has had not eaten much and feels very weak. He is a recent immigrant, does not have a known medical history, and rarely sees medical providers. His temperature is 103°F (39.4°C), blood pressure is 123/85 mmHg, pulse is 138/min, respirations are 14/min, and oxygen saturation is 95% on room air. Physical exam is notable for an uncomfortable man with rigors. A chest radiograph is performed as seen in Figure A. The patient progressively appears worse and has chills, rhinorrhea, and vomiting with notable piloerection. Which of the following is most likely to be found in this patient?