A 40 year old M from Kansas, USA removed an engorged tick from his body few days ago. Today, he presented with fever, headache, and myalgias with a rash, no improvement on doxycycline. Mentation worsens and he becomes obtunded. Initial CBC reveals bone marrow suppression, and he has findings on exam and CXR suggestive of heart failure and respiratory failure. Renal function is worsening and eventually experiences cardiac arrest.
What is your DDx?
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