ABSTRACT
A 35-year-old woman has presented to the emergency department with fever, malaise and neck stiffness. She complains also of a vague history of headache, vertigo and insomnia over the past week. Today she developed fever, photophobia and neck stiffness and a red rash that is blanching and not purpuric. There is no personal history of dental or sinus diseases and no relevant drug history or travel history.
