A 31-year-old woman comes to the physician for a 3-day history of mildly productive cough and fever. Physical examination shows a right lower lobe consolidation with dullness to percussion. She has lymphadenopathy of the head and neck. A peripheral smear is shown.
Which of the following is the most likely explanation for these findings?
A) Chronic lymphocytic leukemia
B) Chronic myelogenous leukemia
C) Cyanocobalamin deficiency
D) Jarisch-Herxheimer reaction
E) Leukemoid reaction
