15 year old boy, 30 hours of flu like illness.  On day of presentation his mother found him febrile and confused in bed.

Assessment on admission 07:30:
Temp 38.2.
HR 103,  BP 148/102
Incoherent and behaving inappropriately.
Some neck stiffness, Kernig’s sign negative.
Movements almost decerebrate.

Purpuric rash noted.

Bloods sent for FBC, clotting, U&E, and culture