Case Study 1: This 19-year-old student was in his usual state of health until the evening prior to admission, when he went to bed with a headache. He told his mother that he felt feverish, and on the following morning his mother found him in bed, moaning and lethargic. He was brought to the emergency room, where he appeared toxic and drowsy, but oriented. His temperature was 40C, his heart rate was 126/min., and his blood pressure was 100/60 mm Hg. He had an impressive purpuric rash (bruise-like), not blanching, most prominent on his trunk, legs and wrists. A gram stain of the material taken from one of the patient’s skin lesions showed gram-negative diplococci. His white blood cell count was 26,000/ml (high) with 25% band forms (high). The platelet count was 80,000/ml (low). Blood cultures were obtained and the patient was begun on intravenous Ceftriaxone. Blood cultures subsequently grew the organism seen on the gram stains of the lesions. Case Study 1 Question 1:  What is the most likely diagnosis for this patient?

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