Problem:
The patient is a male, age 49. He was admitted to the clinic with a high fever, muscle pains (myalgias), and facial swelling around his eyes (periorbital edema). The patient works as a pharmaceutical sales representative based in Hawai'i. He lives in Honolulu, on the island of Oahu. He is married, monogamous, and sexually active, with a 16-year old son. He does not report using drugs of abuse, and rarely drinks alcohol, but does smoke cigarettes (estimates 8 per day). His son has a pet iguana, which he has fed once or twice since his son got it (roughly two years ago). He is allergic to drugs containing sulfonamides. He has a family history of cancer. Within the last year (6 months ago), he and his wife traveled to Thailand to visit extended family. He reports feeling fine during and after his travel. A month ago, he and his family traveled to Maui to attend a street fair celebrating the Thai New Year. While at the fair, he ate several food items from vendors. He felt fine that night; however the following evening he experienced a sudden onset of diarrhea, accompanied by abdominal cramps and heartburn.