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An 11-year-old boy comes to the emergency department because of fever, headache, rash, and mild abdominal pain. He states that he was hiking in the Appalachian Mountains of North Carolina for 4 days as part of a Boy Scout trip. His temperature is 38.3°C (101°F), pulse is 115/min, blood pressure is 95/60 mm Hg, respiratory rate is 14/min, and oxygen saturation is 98% on room air. Examination is most notable for the skin finding shown in the image. Laboratory tests show a WBC count of 16,000/mm³, hematocrit of 46%, and platelet count of 412,000/mm³.
The patient has which of the following conditions that is also reportable to the Centers for Disease Control and Prevention?
B. Lyme disease
D. Rocky Mountain spotted fever
E. Staphylococcal cellulitis
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