The total leukocyte count was 10.9 × 109L, with a normal differential. Hematocrit was 0.26 and platelet count was 725 × 109/L. The Westergren erythrocyte sedimentation rate was 98 mm/h. The C-reactive protein level was elevated to 149 g/L, and the serum electrolyte, blood urea nitrogen, creatinine, albumin, uric acid, and lactic dehydrogenase levels were normal. Serum alanine aminotransferase level was elevated at 69 U/L (normal, 4-46 U/L), but aspartate aminotransferase and bilirubin levels were normal. A urinalysis showed trace hemoglobin. Blood and urine cultures were sterile and stool cultures isolated only normal enteric flora. Serologic testing for coccidioidomycosis, toxoplasmosis, syphilis, hepatitis A virus, hepatitis B virus, and human immunodeficiency virus was negative. Purified protein derivative skin testing was negative, and Candida and tetanus antigen tests were positive.