A 40 year old man presents with jaundice and dull abdominal pain for 1 week, and a high grade, intermittent fever with chills and rigors for 2 weeks. The pain was initially periumbilical, but became generalized over time; it was unaltered by meals or posture.

He is a heavy drinker. There is no history of IV drug abuse or sexual promiscuity. He arrived home 3 weeks ago, after spending a month in Kenya.

His FBC is significant for WBC/DC 14,600/mm3 with 85% neutrophils, Hb 11.9 g/dL, and platelets 130,000/mm3.