A 39-year-old woman is brought to emergency because of a 1-day history of fever, confusion, and lethargy. Temperature is 38 C (100.4 F). Physical examination shows scattered ecchymoses and petechiae. Neurologic examination shows mild-moderate generalized weakness. She is oriented to person but not place or time. Laboratory studies show:
Hemoglobin 9.5 g/dL
Leukocytes 7500/μL
Platelets 20,000/μL
Prothrombin time 12 seconds
Partial thromboplastin time 34 seconds
Blood urea nitrogen 26 mg/dL
A Coombs test is negative. An intravenous exchange transfusion is started. Within a week, her condition rebounds. Which of the following is most likely to be seen in this patient?
