Case records of the Massachusetts General Hospital: Case 5-2014: 2014: A 59-year-old man with fever, confusion, thrombocytopenia, rash, and renal failure.

: A 59-year-old man was admitted to this hospital because of fever, confusion, rash, thrombocytopenia, and renal failure, 10 days after a hunting trip in the Nevada valley. Diagnostic procedures were performed, and diagnostic test results were received from another hospital.