Welcome to the first week of Crack the Case, an interactive web-based discussion of the most intriguing medical diagnoses and cases. Each week, a new case study, as well as the solution for the previous week's study, will be described in depth. I look forward to reading all of your responses! May the odds of Crack the Case: Week One be in your favor!

This week's patient, Thomas Shiffer, is a 22-year-old theology student at the University of Missouri. Born and raised in Columbia, Missouri, Thomas is acclimated to the ever-changing temperatures of Columbia, knowledgeable of the best cup of coffee in town (Shortwave, of course), and warm to the small-town feel of the Mizzou community. Every semester, he travels abroad with Global First Responder to underserved regions of the world in order to provide medical relief. Thomas' parents, as well as his two brothers and five sisters, have all pursued careers in the humanities. Therefore, after his mother passed, four years ago, he could not help but feel that he owed it to his mother and family to continue the family tradition and pursue the less expensive route of Theology rather than medicine. Therefore, for now, Thomas has made it a ritual of attending semester trips to Peru, Haiti, India, in order to serve unconditionally and learn freely.

Upon returning from his most recent trip to Haiti, Thomas has been experiencing a cyclic fever of 99.3° F, roughly every two days, and no other symptoms. Typically, Thomas shivers first, then begins to dry heave and subsequently has a migraine. Upon resting, Thomas feels normal again, however, he begins to sweat profusely before he shivers again (restarting his cycle of symptoms). Worried that he may have contracted an infectious disease, Thomas' father recommends that his other children stay with their aunt until this is resolved. No longer willing to wait, Thomas' father lifts and places him in the backseat of his pickup truck and takes him to the emergency room in the middle of the night. Upon entering the ER, the nurse asks one simple question, "were you bitten by any mosquitoes?" Thomas nods in agreement. A blood smear is immediately ordered by the physician on call and wedding ring-like structures are observed in some, not all, of the red blood cells. In the meantime, Thomas receives an IV and rests with his father until his results come back.

Now it's your turn to crack the case: Please leave a comment guessing what Thomas may have! If you have any questions, please feel free to post those as well. Good luck!