SHO assessment on arrival:
Responsive, mild photophobia, no neck stiffness.
Temperature 39.7.
Pale macular rash over trunk, no purpura.

CVS: Pulse 85 regular, BP 115/75.
Heart sounds normal.
Chest clear, Abdomen normal.

NS: Glasgow coma score 15/15.
Full power in arms and legs- all movements.

Cranial nerves intact, no papilloedema.

14 year old girl admitted to hospital with 24 hour history of fever, increasing headache associated with 6 episodes of vomiting in evening. She has developed photophobia. Also feels generally unwell with myalgia.

GP visited and gave IM penicillin as meningitis considered the most likely diagnosis.  GP arranged transfer to hospital by 999 ambulance