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A 23-year-old man with treatment-resistant schizophrenia started clozapine eighteen days ago and now takes 250 mg daily. He tells the nurse he feels as though he has influenza and is breathless climbing the ward stairs. Temperature is 38.4 degrees C, pulse 122/min, blood pressure 104/68 mmHg and respiratory rate 22/min. There is no rigidity, he is fully orientated, his chest is clear, and his abdomen is soft with bowels open this morning. His neutrophil count two days ago was 4.8 x10^9/L (2.0 to 7.5). Which one of the following complications of clozapine does this presentation most likely represent?
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